Antecedent features of children in whom asthma develops during the second decade of life

In this report we compare 36 subjects in whom asthma was first diagnosed between the ages of 10 and 20 with 297 control subjects. All subjects were studied at age 5 to 9. Among the subjects who acquired a new diagnosis of asthma (NDA), the diagnosis was usually preceded by lower respiratory tract symptoms (31 of the 36 subjects had respiratory symptoms or a diagnosis of rhinitis or chronic bronchitis before asthma developed). Among those tested, more of those with NDA had positive allergy skin test results (56.5%) before diagnosis than control subjects (29.6%; p < 0.05), and the subjects with NDA had higher levels of serum IgE than control subjects (mean log serum IgE = 2.27 in subjects with NDA, 1.76 in control subjects; p < 0.05). Pulmonary function tests revealed no significant differences in the groups before diagnosis. Using logistic regression, we determined that wheezing, cough, a diagnosis of chronic bronchitis, and a positive allergy skin test result were independent risk factors for asthma. When combinations of variables were used, subjects with wheezing and a positive allergy skin test result, cough and a positive test result, and also those with a prior diagnosis of chronic bronchitis alone were at highest risk of a subsequent diagnosis of asthma.