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Paediatric asthma - all that wheezes is not necessarily asthma - current diagnostic and management strategies
Kelsey Lecerf1, Benjamin T Prince
1Division of Allergy and Immunology, Nationwide Children's Hospital, Columbus, Ohio, USA.
Insights
Wheezing in children can be caused by conditions other than asthma. A broad differential diagnosis and careful evaluation of symptoms are crucial for accurate diagnosis and management of pediatric wheezing.
Area of Science:
- Pediatric Pulmonology
- Clinical Pediatrics
- Differential Diagnosis
Background:
- Asthma affects 7% of children in the US and is a common cause of wheezing.
- Wheezing in children often requires considering a broad range of potential diagnoses beyond asthma.
Purpose of the Study:
- To review non-asthma causes of wheezing in pediatric patients.
- To discuss diagnostic and management strategies for pediatric wheezing.
Main Methods:
- Review of clinical characteristics of wheezing.
- Consideration of patient age and medical history.
- Assessment for underlying asthma using updated guidelines.
Main Results:
- Wheezing characteristics, patient age, and history aid in differential diagnosis.
- Updated National Heart, Lung, and Blood Institute guidelines offer diagnostic and management recommendations for asthma.
Conclusions:
- Maintaining a broad differential diagnosis is essential for evaluating pediatric wheezing.
- Comprehensive evaluation guides appropriate management of pediatric wheezing.
Purpose Of Review:
Asthma is a frequently encountered chronic medical condition encountered in paediatrics, affecting 7% of children under the age of 18 in the United States. Although asthma is one of the more common conditions that is associated with wheezing, there is a broad differential diagnosis to consider. The purpose of this review is to describe other causes of wheezing outside of asthma in a paediatric population and discuss diagnostic and management strategies to consider when evaluating a child or adolescent with wheezing.
Recent Findings:
The characteristics of the wheezing along with other associated signs and symptoms can be helpful in narrowing the differential diagnosis. The age and the past medical history of the patient are also important aspects to consider when determining next steps in the evaluation and management of paediatric wheezing. In addition to considering other causes of wheezing, it is often necessary to assess for the presence of underlying asthma, and recently updated asthma guidelines from the National Heart, Lung and Blood Institute provide a graded review of various recommendations for making the diagnosis and managing asthma in the clinical setting.
Summary:
It is important to maintain a broad differential diagnosis when evaluating a paediatric patient with wheezing.
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