Five-year clinical study of children with atopic asthma

Abstract

Background: The continuing increase in child asthma prevalence rates, changes of asthma (A) symptoms lead to difficulties in diagnosis.

Aim: to study the results of five-year clinical study of A in children.

Methods: 42 patients aged 2-18 years old with atopic A were observed during 5 years. All patients were given treatment according to GINA guidelines.

Results: Mild persistent A (MPA) was observed in 27(64.3%) children, moderate persistent (MdPA) - in 15(35.7%). Community-acquired pneumonia (CAP), caused by atypical pathogens was diagnosed in 21(50%) patients with A exacerbation, 15 of which had MdPA (71.4%). In 9(42.9%) asthmatic patients with MdPA CAP episodes occurred annually. 20(47.6%) children with A had allergic rhinitis (AR). In 10(23.8%) patients with MdPA and CAP, pulmonary hypertension (PH) was revealed: in 6 of them (60%) - with pulmonary fibrosis (PF) and recurrent episodes of CAP (RCAP). In 4 patients with A, RCAP, PH and PF (66.7%) CT scans showed emphysematous bullae (EB). As a result of 6-12 month treatment 26(61.9%) patients achieved full A control; in 9(21.4%) children with MdPA, AR and CAP, with antibiotics included in A treatment, control was achieved after 18-30 months, in 7(16.7%) patients with A, RCAP and AR - after 32-36 months.

Conclusions:

1. More than half of children with A exacerbations had CAP caused by atypical pathogens.

2. All children with MdPA had A exacerbation due to CAP, in 60% of them - to RCAP.

3. Almost in a third of asthmatic patients PH was revealed, with PF in 60% of them.

4. In 66.7% of patients with MdPA, RCAP, PH, PF, CT scans showed EB.

5. Achieving A control on the basic treatment with antibacterial therapy extended to 6-24 months in patients with MdPA, AR and CAP.