title: Development of rhinitis may be an indicator for the persistence of childhood asthma.
abstract: OBJECTIVE
  Results of previous studies have established several factors related with the natural course of childhood asthma. The aim of this study is to investigate the prognosis of childhood asthma and to determine possible risk factors for disease persistence.
  
  
  METHODS
  An outpatient cohort with a median (interquartile range) follow-up duration of 19.4 (17.7-21.8) years was re-evaluated. Current clinical remission (CR) was defined as no asthma symptoms and no use of controller medication within the past year.
  
  
  RESULTS
  Out of 115 patients, 78 could be surveyed with questionnaire and 46 patients with a median age of 25.3 (23.9-27.0) years were further investigated with clinical work-up. Nineteen (24.4%) patients were in CR in both visits (adolescence and young adulthood). A further 7 patients (9.0%) who were not in CR at adolescence were in CR at the young adulthood visit. However, 21 patients (26.9%) who were in CR at adolescence were not in CR at the young adulthood visit. Thirty-one patients (39.7%) with persistent symptoms at adolescence were not in CR at young adulthood, either. In multivariate logistic models, the presence of obstructive pattern (forced expiratory volume in 1s (FEV1)/forced vital capacity (FVC) <80% vs. ≥80%) in pulmonary function tests during the adolescence period (odds ratio; [95% confidence interval] (6.71 [1.65-27.29]; p=0.008) and later-onset rhinitis (10.27 [1.18-89.13]; p=0.035) predicted the absence of CR at young adulthood.
  
  
  CONCLUSIONS
  A substantial number of patients who were in CR during adolescence have re-emerging disease. The presence of obstructive pattern in adolescence and later-onset rhinitis were associated with the absence of CR in young adults with asthma. Awareness of risk factors along with early interventions may provide better results in childhood asthma.
authors.affiliation: Hacettepe University, Faculty of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey. Electronic address: styavuz@yahoo.com.
authors.forename: Suleyman Tolga
authors.initials: ST
authors.lastname: Yavuz
authors.affiliation: Hacettepe University, Faculty of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey. Electronic address: ersoycivelek@gmail.com.
authors.forename: Ersoy
authors.initials: E
authors.lastname: Civelek
authors.affiliation: Hacettepe University, Faculty of Medicine, Department of Adult Allergy, 06100 Ankara, Turkey. Electronic address: sulesunmez@yahoo.com.
authors.forename: Sule
authors.initials: S
authors.lastname: Comert
authors.affiliation: Hacettepe University, Faculty of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey. Electronic address: umsahner@yahoo.com.
authors.forename: Umit Murat
authors.initials: UM
authors.lastname: Sahiner
authors.affiliation: Hacettepe University, Faculty of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey. Electronic address: betulbuyuktiryaki@yahoo.com.
authors.forename: Betul
authors.initials: B
authors.lastname: Buyuktiryaki
authors.affiliation: Hacettepe University, Faculty of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey. Electronic address: tuncerayfer@yahoo.com.
authors.forename: Ayfer
authors.initials: A
authors.lastname: Tuncer
authors.affiliation: Hacettepe University, Faculty of Medicine, Department of Adult Allergy, 06100 Ankara, Turkey. Electronic address: kalyon@ada.net.tr.
authors.forename: Ali Fuat
authors.initials: AF
authors.lastname: Kalyoncu
authors.affiliation: Hacettepe University, Faculty of Medicine, Department of Pediatric Allergy, 06100 Ankara, Turkey. Electronic address: b_sekerel@yahoo.com.
authors.forename: Bulent Enis
authors.initials: BE
authors.lastname: Sekerel
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D000402:Airway Obstruction / Q000209:etiology / Q000503:physiopathology; D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D016017:Odds Ratio; D012008:Recurrence; D012129:Respiratory Function Tests; D012220:Rhinitis / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D018570:Risk Assessment; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Childhood asthma; Later-onset rhinitis; Prognosis; Remission; Risk factors; Young adulthood