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[Bronchial asthma in the 2d and 3d year of life]
Insights
Early diagnosis of extrinsic asthma in children under three is crucial. Many cases begin between ages one and three, impacting lung development and recovery. Early intervention preserves respiratory function.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Clinical Diagnostics
Context:
- Extrinsic asthma often manifests before age three, with 45.2% of cases appearing between one and three years old.
- Delayed diagnosis in young children can lead to impaired lung development and reduced recovery due to mucus retention and decreased lung capacity.
- Immature respiratory structures in children are more susceptible to damage from prolonged asthma symptoms.
Purpose:
- To investigate the age of onset for extrinsic asthma in children aged 1-3 years.
- To evaluate diagnostic methods, including immunoallergic parameters (skin tests, RAST) and clinical history, for identifying extrinsic asthma.
- To correlate diagnostic findings with disease severity and suggest appropriate therapeutic strategies.
Summary:
- A study of 242 children (1-3 years) with obstructive respiratory syndromes identified a high incidence of extrinsic asthma onset between the second and third years (45%).
- Diagnostic methods, including skin prick tests and Radioallergosorbent Test (RAST), were used to classify patients into four groups based on etiology (house dust/mites, moulds) and severity.
- Early diagnosis is critical, as over 50% of children in the second and third years showed positive or suggestive results for extrinsic allergic asthma, highlighting the need for timely intervention.
Impact:
- Emphasizes the importance of early diagnosis and intervention in pediatric extrinsic asthma to prevent long-term respiratory damage.
- Highlights the diagnostic utility of immunoallergic testing in conjunction with clinical evaluation for accurate disease identification in young children.
- Provides a framework for understanding disease progression and tailoring treatment based on specific allergic triggers and disease severity.
Abstract:
In studying age of onset in our cases of extrinsic asthma, we found that symptomatology occurred in 50% of our patients before the age of 3, and in 45.2% between the first and third year of life. We are therefore concerned about children coming to our service after a long period of illness, since difficulty of recuperation correlates with the duration of asthma. When the onset of asthma is between the first and third years, the child is not yet familiar with his own body's function, and learns how to live as an asthmatic with decreased lung capacity in the intercritic period. As noted by Shepherd, the retention of mucus in a child's lungs will impair the respiratory function more than it does in the adult, since the lesion of an immature structure may hinder its normal development. It is therefore important at this age to maintain respiratory function. 242 children aged between 1 and 3 were studied, who suffered from obstructive respiratory syndromes whose etiology was determined by clinical history and immunoallergic parameters, both "in vivo" and "in vitro". The correlation between the RAST and skin test values by planimetry was also studied. 4 groups were distinguished according to the Foucard score: Group I: consisted of children with a clinical history suggestive of extrinsic allergic asthma due to house dust/mites, with positive skin tests and RAST positive 3-4. Group IIa: also suggestive of extrinsic allergic asthma, with positive clinical history, positive skin test and RAST O. Group IIb: with a positive clinical history, positive skin test and RAST 1-2. Group III: consisted of children with obstructive bronchitis, and uncertain clinical history, negative skin and inhalant tests and RAST O. Group IV: consisted of children with extrinsic asthma due to moulds, with a suggestive clinical history, positive skin tests and RAST 1-2-3-4. Diagnostic methods and therapy in the different groups are discussed. There is a high incidence of onset between the 2nd and 3rd year of age (45%). In the pediatric allergic service the incidence of onset in this age group is only 7.8%. Early diagnosis is essential to avoid damage to lung function in the intercritic period. Difficulty of diagnosis: in the 2nd year we found 38.4% positive and 15.5% suggestive results, totalling 53.9%; and in the 3rd year we found 45.7% positive and 6.2% suggestive results, totalling 51.9%, giving us a more than 50% possibility of extrinsic allergic asthma as the diagnosis.