title: Severe episodic viral wheeze in preschool children: High risk of asthma at age 5-10 years.
abstract: In population studies, most children with episodic viral wheeze (EVW) become symptom free by 6 years. We studied the outcome of children with severe EVW, treated and followed up in hospital. We followed up 78 children <4 years, managed by paediatricians for severe EVW, to the age of 5-10 years. We recorded respiratory symptoms, spirometry and exhaled nitric oxide (FeNO). At follow-up, 42 children (54%) had current wheeze or dyspnoea, and 52 (67%) had current asthma. There was no significant difference between children with and without current asthma in FEV1 (p = 0.420), but FeNO was higher in children with current asthma (median (interquartile range) 14.5 (11.25-21.50) ppb) than in those without (12.0 (10.0-13.8) ppb, p = 0.020). Positive family history of asthma was the only factor associated with current asthma (odds ratio 8.77, 95% CI 2.88-26.69, p < 0.001). This remained significant after adjustment for duration of follow-up, gender and parental smoking. Conclusion. Severe EVW at preschool age has a high risk of asthma at age 5-10 years, and this is reinforced by a positive family history of asthma and to elevated FeNO levels.
authors.affiliation: Princess Amalia Children's Clinic, Isala klinieken, PO Box 10400, 8000, GK, Zwolle, the Netherlands.
authors.forename: Lucie
authors.initials: L
authors.lastname: Kappelle
authors.forename: Paul L P
authors.initials: PL
authors.lastname: Brand
mesh_terms: D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004417:Dyspnea / Q000150:complications / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D012008:Recurrence; D012135:Respiratory Sounds; D012141:Respiratory Tract Infections / Q000150:complications* / Q000503:physiopathology / Q000821:virology; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014797:Vital Capacity
chemical_list: D018927:Anti-Asthmatic Agents