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Variation of asthma characteristics with atopic march, gastroesophageal reflux, and ENT pathologies
Norane Shehab1, Jobayer Hossain2, Ejaz Yousef3
1Department of Pediatrics, UF Health Jacksonville, Jacksonville, FL, USA.
Insights
Pediatric asthma patients with atopic march experience more severe symptoms and higher morbidity. Those without atopic march have milder asthma, requiring fewer steroids and hospitalizations, but show increased ENT and GER issues.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Dermatology
Background:
- Asthma significantly impacts pediatric morbidity and mortality.
- Atopic dermatitis (AD) often initiates the atopic march, predicting future allergic conditions like asthma.
Purpose of the Study:
- To compare asthma severity in pediatric patients with and without the atopic march.
- To investigate the characteristics of asthmatic children with GER and ENT pathologies.
Main Methods:
- 616 pediatric asthmatic patients were divided into two groups: with AD history (Group A) and without AD history (Group B).
- Factors analyzed included demographics, family history, allergic comorbidities, environmental exposures, ENT pathologies, GER, steroid use, and hospital admissions.
Main Results:
- Asthmatic children with atopic march exhibited higher asthma severity and morbidity.
- Patients without atopic march had milder asthma, reduced steroid dependence, and fewer hospital admissions.
- A higher prevalence of ENT pathologies and/or GER was observed in asthmatic children without atopic march.
Conclusions:
- Asthma patients with atopic march present a more severe phenotype with increased morbidity.
- Asthma patients without atopic march demonstrate a milder phenotype, with less need for medical intervention but a higher incidence of ENT and GER conditions.
Background:
Asthma is a significant cause of morbidity and mortality in the pediatric population. Atopic dermatitis (AD) is often the first step in the atopic march leading to the development of asthma, allergic rhinitis, and food allergies in the future.
Objective:
This study aimed to evaluate the severity differences between asthmatic children with and without atopic march in addition to characteristics of asthmatic patients with GER and ear-nose-and-throat (ENT) pathologies.
Methods:
A total of 616 pediatric asthmatic patients were enrolled. The study subjects were divided into two groups. Group A included asthmatic children with a history of AD. Group B had asthmatic children without a history of AD. Multiple factors were studied, including sex, race/ethnicity, family history of atopy, asthma severity, allergic rhinitis, food allergies, smoke exposure, ear-nose-and-throat (ENT) pathologies, gastroesophageal reflux (GER), frequency of systemic steroid use, and hospital admission rates.
Results:
Our results revealed that patients with atopic march are at risk of developing a higher severity of asthma, resulting in increased morbidity. In contrast, asthmatic patients without atopic march had a milder asthma severity, less need for steroids, and fewer hospital admissions. A higher prevalence of ENT pathologies and/or GER existed among asthmatic children without atopic march.
Conclusion:
Our findings suggest that patients with atopic march should be expected to exhibit a more severe phenotype of asthma with increased asthma morbidity. Asthmatic patients without atopic march had a milder asthma phenotype, less need for steroids, and fewer hospital admissions. A higher prevalence of ENT pathologies and/or GER existed among asthmatic children without atopic march.
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