[Long-term follow up studies of bronchial asthma in children. II. Prognosis and complications, treatment and allergic evaluations].
A questionnaire on the prognosis of bronchial asthma was sent in 1988 to 1592 patients (1038 males, 554 females) averaging 20 years of age after 12 years' follow up. We reported on the prognosis and risk factors associated with asthmatic children in part I. The relation between prognosis and other allergic complications, treatment and laboratory data were investigated in this study. Eosinophil counts of more than 1000/mm3 and/or total serum IgE levels of more than 500 IU/ml (100 IU/ml in infants) indicated poor prognosis. However, the prognosis was not affected either by the allergens themselves or by the number of allergens determined by skin test and RAST. The prognosis was worse for patients with multiple allergic complications than for those without complications. Treatment may after the natural course of childhood asthma, but it has been difficult to evaluate the effect of each regimen over a long period. We compared the effect of hyposensitization (specific immunization) and non-bronchodilator antiasthmatic drugs (NBAAD), and found that hyposensitization alone gave better results than NBAAD and its combination. We had better results from hyposensitization over a period of 1 to 5 years than for less than 1 year or more than 5 years. We conclude that asthmatic children with risk factors should be kept under strict environmental control and given suitable therapeutic regimens to avoid the development of allergic diseases, the slow down of "allergic march", and to avoid intractable asthma.
Maruo
H
H
Department of Pediatrics, Kudanzaka Hospital.
Hashimoto
K
K
Shimoda
K
K
Shimanuki
K
K
Nakayama
T
T
Yamaguchi
H
H
Shiigai
N
N
Uchimura
K
K
Mitsubayashi
T
T
Akasaka
T
T
D001249:Asthma / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D003888:Desensitization, Immunologic; D004358:Drug Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D011379:Prognosis; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors