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An approach to preschool wheezing: to label as asthma?

Hugo P Van Bever1, Eugene Han, Lynette Shek

  • 1From the Department of Pediatrics, YLL School of Medicine, National University, Singapore.

The World Allergy Organization Journal
|January 4, 2013
PubMed

Insights

Preschool wheezing is not always asthma; it can be virus-induced with a good prognosis or multitrigger with allergic links. Treatment varies, with leukotriene-receptor antagonists for prevention and cautious use of inhaled corticosteroids.

Area of Science:

  • Pediatrics
  • Pulmonology
  • Allergy & Immunology

Background:

  • Preschool wheezing is common, but not all cases signify persistent asthma.
  • Differentiating between virus-induced and multitrigger wheezing is crucial for prognosis and treatment.
  • The long-term efficacy of anti-inflammatory agents in preschool wheezing remains under investigation.

Purpose of the Study:

  • To provide an expert opinion on preschool wheezing phenotypes.
  • To discuss the association between preschool wheezing and the development of asthma.
  • To outline current treatment strategies for different wheezing phenotypes.

Main Methods:

  • This is a review article, synthesizing existing literature and expert opinion.
  • Classification of preschool wheezing into distinct phenotypes is discussed.
  • Treatment options and their evidence base are critically evaluated.

Main Results:

  • Virus-induced wheezing is the most frequent type, typically resolving over time.
  • Multitrigger wheezing is linked to allergic predispositions and a greater risk of persistent symptoms.
  • Inhaled corticosteroids may offer short-term benefits, but long-term advantages are not definitively established.

Conclusions:

  • Preschool wheezing requires careful phenotyping to guide management.
  • Virus-induced wheezing generally has a favorable outcome.
  • Further research is needed to establish optimal long-term anti-inflammatory strategies for persistent preschool wheezing.

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