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Asthma as a child. Symptom-free as an adult?
1Department of Pediatrics, Central Hospital, Växjö, Sweden.
Insights
Childhood asthma hospitalizations can lead to long-term health issues. Even symptom-free adults may have hyperreactive airways and lingering allergy symptoms, indicating asthma
Area of Science:
- Pulmonology
- Allergy and Immunology
- Epidemiology
Background:
- Childhood asthma hospitalizations represent a significant burden.
- Long-term outcomes for individuals hospitalized with asthma in childhood are not fully understood.
- Assessing the persistence of asthma-related conditions into adulthood is crucial for patient management.
Purpose of the Study:
- To investigate the long-term health status of individuals hospitalized for asthma during childhood.
- To determine the prevalence of persistent asthma symptoms, airway hyperreactivity, and allergic conditions in adulthood.
- To evaluate the relationship between childhood asthma severity and long-term health outcomes.
Main Methods:
- A retrospective cohort study of 123 individuals hospitalized for asthma between ages 5-15 years (1953-1962).
- Follow-up conducted 23-31 years later using survey questionnaires and clinical re-examinations.
- Assessment included symptom reporting, lung function tests, methacholine provocation tests, skin prick tests, and Phadiatop allergy tests.
Main Results:
- Three out of four deaths in the cohort were asthma-related.
- Of 117 responders (98% response rate), 53% reported being completely symptom-free.
- Among symptom-free adults, 23% exhibited airway hyperreactivity, and high percentages showed positive allergy tests (80%) and allergic rhinoconjunctivitis (61%).
Conclusions:
- A significant proportion of adults hospitalized for asthma in childhood remain symptom-free but may have persistent underlying airway hyperreactivity.
- The presence of allergy and hyperreactivity in symptom-free individuals suggests that complete allergy resolution may not be necessary for perceived health restoration.
- Childhood asthma hospitalizations are associated with long-term health implications, including potential for persistent airway dysfunction and allergic conditions.
Abstract:
Of 123 individuals hospitalized as children (aged 5-15 years) because of asthma over a 10-year period (1953-1962), four are dead of whom three died of asthma at follow-up 23-31 years later. Using a survey questionnaire, 64 (53%) of the 117 responders (response rate 98%) claimed to be completely symptom-free. The rest were still suffering from their disease. Of the 31 symptom-free individuals still living in the community, two had decreased lung volumes and seven had positive methacholine provocation tests at re-examination, thus indicating hyperreactivity. Twenty-five individuals showed both positive skin prick tests and Phadiatop allergy tests. Nineteen individuals were suffering from allergic rhinoconjunctivitis. So, of symptom-free adults hospitalized for asthma in childhood, nearly a quarter (23%) had hyperreactive airways. The occurrence of positive skin prick test/Phadiotop and rhinoconjunctivitis was, however, even higher (80% and 61% respectively), thereby indicating that the disappearance of allergy may not be a prerequisite for restoration to health in asthma.