Asthma, lung function and sensitization in school children with a history of bronchiolitis.
BACKGROUND
The purpose of the present retrospective study was to investigate the association of school-age asthma with acute-bronchiolitis and examine the influence of potential risk factors.


METHODS
One hundred and eighty-nine children aged 7.5 +/- 2.2 years consecutively hospitalized for respiratory syncytial virus (RSV)-positive acute bronchiolitis during infancy were evaluated by clinical examination and measurement of peak expiratory flow (PEFR), spirometry, IgE and skin-prick testing. Their pulmonary function was compared with that of 60 non-asthmatic matched controls.


RESULTS
Of the entire cohort 57.1% were diagnosed as asthmatic. PEFR, the 1-second forced expiratory volume and forced expiratory flow of 50% vital capacity of children with a history of acute bronchiolitis were statistically significantly lower than in the control group (all P < 0.001). All the aforementioned measurements of children with/without asthma were also significantly lower than controls, while values of asthmatics were significantly lower than those of non-asthmatics. The incidence of asthma in childhood was independently associated with breast-feeding <3 months (adjusted odds ratio [aOR], 8.4; 95% confidence interval [CI]: 3.1-22.4), at least one positive skin prick test (aOR, 7.1; 95%CI: 2.8-18.1), male gender (aOR, 5.0; 95%CI: 2.2-11.5), evidence of moisture in the home environment (aOR, 2.9; 95%CI: 1.3-6.3) and presence of more than one house-resident smoking indoors (aOR, 4.9; 95%CI: 1.8-9.2).


CONCLUSIONS
Children with a history of RSV-bronchiolitis during infancy have an increased risk for developing asthma in childhood, which was independently associated with male gender, breast-feeding <3 months, living in a home environment with moisture damage and/or tobacco smoke by two or more residents and sensitization to at least one aeroallergen. Children with a history of RSV bronchiolitis in infancy had lower spirometry in comparison to matched control group. The difference was more marked for asthmatic ones but remained significant even for non-asthmatic children.
Cassimos
Dimitrios C
DC
Department of Paediatrics, Univesity General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece. kassimos@pathfinder.gr
Tsalkidis
Aggelos
A
Tripsianis
Gregorios A
GA
Stogiannidou
Anastasia
A
Anthracopoulos
Michael
M
Ktenidou-Kartali
Sofia
S
Aivazis
Victor
V
Gardikis
Stefanos
S
Chatzimichael
Athanasios
A
D000293:Adolescent; D001249:Asthma / Q000209:etiology* / Q000503:physiopathology*; D001991:Bronchitis / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D012129:Respiratory Function Tests; D012130:Respiratory Hypersensitivity / Q000150:complications*; D018357:Respiratory Syncytial Virus Infections / Q000150:complications*; D012189:Retrospective Studies