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Clinical and Laboratory Characteristics and Comorbidities in Asthma Endotypes in Children
Gautam Kumar1, Saroj Kumar Tripathy2, Sarthak Das3
1MBBS student, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
Insights
Eosinophilic asthma is the most common type in children, with allergic rhinitis being a frequent comorbidity. Urticaria was notably higher in non-eosinophilic asthma endotypes.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Clinical Medicine
Background:
- Asthma in children presents diverse endotypes, influencing clinical presentation and management.
- Understanding the prevalence and characteristics of eosinophilic versus non-eosinophilic asthma is crucial for targeted therapies.
- Comorbidities frequently coexist with pediatric asthma, potentially impacting disease severity and outcomes.
Purpose of the Study:
- To determine the proportion of eosinophilic and non-eosinophilic (NEA) asthma endotypes in pediatric patients.
- To compare clinical, laboratory, and comorbidity profiles between eosinophilic asthma (EA) and NEA endotypes in children.
- To identify specific comorbidities associated with each asthma endotype in a pediatric cohort.
Main Methods:
- A cross-sectional study included 150 children (5-14 years) with confirmed asthma in Eastern India.
- Evaluated complete hemogram, absolute eosinophil count (AEC), IgE, and pulmonary function tests.
- Recorded asthma comorbidities and managed patients per Global Initiative for Asthma (GINA) guidelines.
Main Results:
- Eosinophilic asthma comprised 88.7% of cases, while NEA constituted 11.3%.
- Allergic rhinitis (59.3%) was the most common comorbidity, followed by cold exposure (42%) and anxiety (26.7%).
- Urticaria showed a significantly higher association with NEA endotype (OR 4.0; P=0.02), while prematurity was also linked to NEA.
Conclusions:
- Eosinophilic asthma is the predominant endotype in the pediatric population studied.
- Allergic rhinitis is the most frequent comorbidity associated with pediatric asthma.
- While most comorbidities were similar, urticaria was significantly more prevalent in the non-eosinophilic asthma endotype.
Objective:
To estimate the proportion of eosinophilic and non-eosinophilic (NEA) endotypes in pediatric asthma, and to compare the clinical, and laboratory characterisitics, and different comorbidities between the two endotypes in the children.
Methods:
Children aged 5 to 14 years of age with clinical and/or laboratory-confirmed asthma attending the pediatric outpatient department of a tertiary care hospital in Eastern India between October 1, 2023 and March 31, 2024, were included in this cross-sectional study. Complete hemogram, absolute eosinophil count (AEC), IgE, and pulmonary function tests were performed in all patients. Comorbidities associated with asthma were recorded. All patients were managed as per the Global Initiative for Asthma (GINA) guidelines.
Results:
Of 150 patients, 133 (88.7%) patients belonged to eosinophilic asthma and 17 (11.3%) belonged to NEA endotypes. A family history of allergy and/or asthma was observed in 83 (55%) participants. Allergic rhinitis (59.3%), exposure to cold (42%), and anxiety (26.7%) were common comorbidities associated with asthma. Prematurity and urticaria were significantly associated with NEA. On regression analysis, the odds of urticaria among the NEA endotype were about 3.7 times higher than the EA endotype, adjusted odds ratio (95% CI) of 4 (1.3, 12.6), P value = 0.02. Other comorbidities, sociodemographic, clinical, and lung function values were similar in both endotypes of asthma.
Conclusion:
Eosinophilic asthma is the commonest asthma endotype and allergic rhinitis is the commonest comorbidity observed in children. Comorbidities associated with asthma in children are usually similar in both endotypes except for urticaria which is higher in NEA.
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