Related Experiment Video
Updated: Jul 7, 2026
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
[Infancy asthma: diagnostic and therapeutic approach]
Monia Khemiri1, Siham Barsaoui
1Service de Médecine infantile A Hôpital d'enfants, Tunis.
Insights
Diagnosing and treating infant asthma is challenging due to its varied presentations. Early atopy is a key risk factor for persistent asthma in wheezy infants, guiding treatment decisions.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Allergy and Immunology
Background:
- Infant asthma presents with recurrent wheezing and dyspnea within the first two years.
- It's a heterogeneous condition with diverse phenotypes, complicating diagnosis and treatment.
- Wheezing in infants can mimic asthma, making accurate diagnosis difficult.
Purpose of the Study:
- To systematically review the management of recurrent wheezing in infants.
- To address diagnostic criteria, treatment strategies, and long-term outcomes.
- To clarify when wheezing in infants constitutes asthma.
Main Methods:
- Conducted an electronic literature search in Medline.
- Included meta-analyses, RCTs, systematic reviews, cohort studies, and consensus reports.
- Utilized keywords: "infant", "wheezing", "atopy", "asthma", "inhaled corticosteroids".
Main Results:
- Diagnosing infant asthma is difficult due to overlapping symptoms and challenges in assessing bronchial hyperresponsiveness.
- Identified three infant wheezing groups: transient early, persistent non-atopic, and persistent atopic (asthmatic).
- Early bronchial inflammation is noted, supporting inhaled corticosteroids as a primary treatment.
Conclusions:
- Atopy in infants with recurrent wheezing is the primary risk factor for developing persistent asthma.
- Current indicators for predicting future asthma in infants are unreliable.
- Management of asthmatic infants is complex due to their unique respiratory characteristics.
Background:
Asthma in infants is characterized by recurrence of three episodes of dyspnea and wheezing within two first years of age. Asthma in infancy is a heterogeneous condition with different clinical phenotypes and outcome. So, the diagnostic and therapeutic approach are often difficult. THE AIM of this systematic review was to provide answers to the following questions in the management of recurrent wheeze in infants: is it asthma?, should we treat wheezy infants?, what are the modalities of prescriptions? what is the long term outcome of wheezy infants?
Methods:
Electronic literature search was performed in Medline. Key-words used for the final search were "infant", "wheezing", "atopy", "asthma", "inhaled corticosteroids". We considered for analysis meta analysis, randomized controlled trials, systematic reviews, cohort studies and consensus statement reports.
Results:
The diagnosis of asthma in infants is more difficult than in older children or adults since many causes of eezing" may simulate an asthma associated to difficulties to evaluate bronchial hyper responsiveness in this age. There are three groups of wheezy infants: transient early wheezers, persistent non atopic wheezers and persistent atopic wheezers or asthmatic. Since recent data have proved early bronchial inflammation in wheezy infants, inhaled corticosteroids have become the main treatment. However, management of asthmatic infants is more difficult according to anatomic and functional respiratory peculiarities. There is no reliable clinical or biological indicators of future asthma. The evidence of atopy in infants with recurrent wheezing seems to be the main risk factor of the development of persistent asthman.
Related Concept Videos
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:30Asthma-IV: Nursing Management
First, in...
01:28Asthma I: Introduction
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...