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[Results of a screening for atopy and aspecific bronchial hyperreactivity in 6-year-old children]
Insights
Asthma diagnosis in children involves assessing atopy and bronchial reactivity. Many children with asthma symptoms or family history show increased bronchial hyperresponsiveness to methacholine.
Area of Science:
- Pediatric Pulmonology
- Allergology
- Clinical Immunology
Background:
- Childhood asthma diagnosis relies on clinical history, allergen sensitivity, and bronchial reactivity.
- Atopy, a genetic predisposition to allergic diseases, is a significant risk factor for asthma.
- Assessing non-specific bronchial hyperresponsiveness is crucial for diagnosing and managing asthma.
Purpose of the Study:
- To investigate the prevalence of atopy and bronchial hyperresponsiveness in children with suspected asthma.
- To correlate clinical symptoms and family history of atopy with objective measures of asthma.
- To evaluate methacholine bronchial reactivity as a diagnostic tool in pediatric asthma.
Main Methods:
- Clinic-anamnestic study involving 1569 primary school children, with 622 selected for asthma evaluation.
- 358 children underwent further respiratory assessment, including allergy skin prick tests and methacholine bronchial challenge.
- A control group of 12 children without atopic or asthmatic tendencies was included.
Main Results:
- A family history of atopy was present in 81.1% of the studied children, with maternal tendency being most common.
- Skin prick test positivity was higher in symptomatic children (59.82%) compared to asymptomatic children with atopic family history (27.56%).
- Increased bronchial reactivity to methacholine was observed in 62% of asymptomatic and 84.69% of symptomatic children.
Conclusions:
- Family history of atopy is highly prevalent in children with potential asthma.
- Both allergic sensitization (skin tests) and bronchial hyperresponsiveness are significantly associated with asthma symptoms in children.
- Methacholine bronchial reactivity is elevated in children with asthma, rhinitis, and chronic cough, indicating its utility in pediatric respiratory assessment.
Abstract:
In the course of a clinic-anamnestic study performed from November 1984 to April 1985 by the collaborators of USL 40 Maternal-Infantile Service, among the children (1569) of the first primary school, 622 children has been selected for possible, probable and verified asthma. For making deeper the diagnosis, 358 children had gone to the respiratory allergologic section of division of pneumology and respiratory allergology of Cardarelli Hospital. The control group was formed from 12 children without atopic familiarity and without asthmatic tendency. Among the 358 children, 127 were asymptomatic but with familiar anamnesis positive for atopy; 219 had or had suffered allergic symptomatology. The authors had studied all children by Prick-test with a standard battery of allergens and with by methacholine aspecific bronchial reactivity test. The familiar tendency to atopy was present in 81.1% of studied children, with prevalence of maternal tendency (41,83%) in comparison with this of ascendents and collaterals. Among the asymptomatic subjects with atopic familiarity only 27.56% was skin positive for one or more allergens, while 59.82% of symptomatic subjects was skin positive. The bronchial aspecific reactivity with methacholine was increased in the 62% of asymptomatic and in the 84.69% of symptomatic subjects. The aspecific bronchial reactivity level in mean was higher in the children with bronchial asthma but also the subjects with rhinitis and chronic cough has showed a higher level in comparison with adults affected of similar symptomatology. In 8 children the authors have studied the reproduction of PD20 methacholine which was very high.