[A retrospective survey on the respiratory course of severe bronchiolitis].
BACKGROUND
Respiratory syncytial virus (RSV) infection in infancy can induce bronchial reactivity and virus-specific IgE production; these responses may favor the later development of asthma. This retrospective study examines the influences of early and severe forms of bronchiolitis on such an outcome.


METHODS
The files of 43 infants who had spent 1 to 24 days (mean 7.8 days) in intensive care between 1986-1990 for severe bronchiolitis with apnea and/or hypercapnia and/or hypoxemia were studied. The parents of all these children agreed to answer a standard questionnaire covering perinatal events, gestational age, number and frequency of recurrent episodes of wheezing, personal and familial history of allergy and environmental conditions. 15 of the children were preterm and 12 of them were given respiratory support during the neonatal period; 5 of these patients developed broncho-pulmonary dysplasia. RSV was isolated in 20 of 39 patients.


RESULTS
26 of the 41 surviving patients developed at least 3 episodes of wheezing over periods ranging from 5 to 54 months (mean 27.6 months): 15 of them were admitted at least once for asthma and 17 were given long-term bronchodilators and/or corticosteroids. Of the 8 patients with histories of allergy, 6 developed asthma, as did 7 of the 9 that had been in close contact with other children, and 9 of the 15 patients who had been exposed to tobacco.


CONCLUSIONS
Not only is the development of asthma associated with risk factors (RSV infection, bronchopulmonary dysplasia, history of allergy, close contact with other children and exposure to tobacco) but the severity of the bronchiolitis per se is also correlated with this risk.
Bodart
E
E
Centre de Diagnostic et de Traitement de l'Asthme de l'Enfant, Hôpital d'Enfants Armand-Trousseau, Paris.
Just
J
J
Grimfeld
A
A
Costil
J
J
D001249:Asthma / Q000209:etiology; D001990:Bronchiolitis, Viral / Q000150:complications / Q000503:physiopathology*; D001997:Bronchopulmonary Dysplasia / Q000150:complications; D003876:Dermatitis, Atopic / Q000150:complications; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
Enquête rétrospective sur l'évolution respiratoire des bronchiolites graves.