RT Journal Article
SR Electronic
T1 Assessment of problematic severe asthma in children
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 432
OP 440
DO 10.1183/09031936.00091410
VO 37
IS 2
A1 K.C. Lødrup Carlsen
A1 G. Hedlin
A1 A. Bush
A1 G. Wennergren
A1 F.M. de Benedictis
A1 J.C. De Jongste
A1 E. Baraldi
A1 C. Pedroletti
A1 A. Barbato
A1 K. Malmström
A1 P. Pohunek
A1 S. Pedersen
A1 G.L. Piacentini
A1 R.J.M. Middelveld
A1 K.H. Carlsen
YR 2011
UL http://erj.ersjournals.com/content/37/2/432.abstract
AB Assessment of problematic severe asthma in children should be performed in a step-wise manner to ensure an optimal approach. A four-step assessment scheme is proposed. First, a full diagnostic work-up is performed to exclude other diseases which mimic asthma. Secondly, a multi-disciplinary assessment is performed to identify issues that may need attention, including comorbidities. Thirdly, the pattern of inflammation is assessed, and finally steroid responsiveness is documented. Based upon these four steps an optimal individualised treatment plan is developed. In this article the many gaps in our current knowledge in all these steps are highlighted, and recommendations for current clinical practice and future research are made. The lack of good data and the heterogeneity of problematic severe asthma still limit our ability to optimise the management on an individual basis in this small, but challenging group of patients.