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Non-IgE-mediated asthma in children.

P A Ostergaard

    Acta Paediatrica Scandinavica
    |September 1, 1985
    PubMed
    Summary

    Children with non-IgE-mediated ("intrinsic") asthma experience more severe lung issues and hospitalizations than those with IgE-mediated ("extrinsic") asthma. Intrinsic asthma can progress severely in childhood.

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    Area of Science:

    • Pediatric Pulmonology
    • Allergy and Immunology
    • Respiratory Medicine

    Background:

    • Asthma in children is broadly classified into IgE-mediated (extrinsic) and non-IgE-mediated (intrinsic) types.
    • Understanding the distinct characteristics and progression of these asthma phenotypes is crucial for effective management.

    Purpose of the Study:

    • To compare the clinical characteristics, disease progression, and microbial profiles of children with intrinsic asthma versus extrinsic asthma.
    • To identify potential differences in disease severity and outcomes between these two pediatric asthma subtypes.

    Main Methods:

    • A three-year observational study involving 586 children diagnosed with asthma.
    • Categorization based on immunoglobulin E (IgE) levels and allergen sensitivity.
    • Assessment of lung function, hospital admission rates, serum immunoglobulin levels (IgG, IgM), and lower airway microbial cultures.

    Main Results:

    • Children with intrinsic asthma (12%) showed significantly more lung hyperinflation, hospital admissions (asthma/pneumonia), elevated serum IgG and IgM, and positive cultures for Haemophilus influenzae and pneumococci compared to extrinsic asthma patients.
    • Eleven children with intrinsic asthma exhibited progressive disease, including declining forced vital capacity and signs of lung fibrosis despite corticosteroid treatment.

    Conclusions:

    • Intrinsic asthma in children may represent a distinct clinical entity with a potential for severe, progressive disease within a few years.
    • These findings highlight the need for tailored management strategies for children with intrinsic asthma due to its potentially aggressive course.

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