title: Stability and predictiveness of multiple trigger and episodic viral wheeze in preschoolers.
abstract: In 2008, the European Respiratory Society Task Force proposed the terms multiple-trigger wheeze (MTW) and episodic (viral) wheeze (EVW) for children with wheezing episodes. We determined MTW and EVW prevalence, their 24-month stability and predictiveness for asthma.
  
  
  
  In total, 565 preschoolers (1-, 2- and 3-year-olds) in primary care with respiratory symptoms were followed until the age of 6 years when asthma was diagnosed. MTW status and EVW status were determined using questionnaire data collected at baseline and after one and 2 years. We distinguished 3 phenotypes and determined their 24-month stability, also accounting for treatment with inhaled corticosteroids (ICS). Logistic regression was used to analyse the phenotypes' associations with asthma.
  
  
  
  Two hundred and eighty-one children had complete information. MTW and EVW were stable in 10 of 281 (3.6%) and 24 of 281 (8.5%), respectively. The odds of developing asthma for children with stable MTW and stable EVW were 14.4 (1.7-119) and 3.6 (1.2-11.3) times greater than those for children free of wheeze (for at least 1 year). ICS was associated with increased stability of MTW and EVW.
  
  
  
  Stable multiple-trigger and stable episodic viral wheeze are relatively uncommon. However, 1- to 3-year-olds with stable MTW are at much increased risk of asthma.
authors.affiliation: Health Inspectorate, The Hague, The Netherlands.
authors.forename: K E
authors.initials: KE
authors.lastname: van Wonderen
authors.affiliation: Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: R B
authors.initials: RB
authors.lastname: Geskus
authors.affiliation: Pediatric Respiratory Medicine and Allergy, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: W M C
authors.initials: WM
authors.lastname: van Aalderen
authors.affiliation: Department of General Practice, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Mohrs
authors.affiliation: Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: P J E
authors.initials: PJ
authors.lastname: Bindels
authors.affiliation: Department of General Practice, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: L B
authors.initials: LB
authors.lastname: van der Mark
authors.affiliation: Department of General Practice, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: G
authors.identifier: 0000-0002-2231-7637
authors.initials: G
authors.lastname: Ter Riet
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007223:Infant; D008297:Male; D010641:Phenotype; D011159:Population Surveillance; D015995:Prevalence; D011379:Prognosis; D012135:Respiratory Sounds / Q000209:etiology*; D012307:Risk Factors; D014777:Virus Diseases / Q000150:complications*
chemical_list: D000305:Adrenal Cortex Hormones; D007073:Immunoglobulin E
keywords: asthma; cohort studies; episodic viral wheeze; multiple-trigger wheeze; preschool children; primary health care