A Long Term Follow-up Study of Prognostic Factors in Infantile Asthma (Report I)

Kim, Hyo Jung; Kim, Dong Jun; Oh, Jae Won; Lee, Ha Baik

Abstract

PURPOSE
Asthma has been known as a chronic inflammatory disease to cause airway obstruction by allergens, viral infections and other factors. Nowdays infantile asthma is increasing markedly. However, to date the enough study for predicting its long term prognosis was not performed. This study aimed to estimate the long term prognosis of infantile asthma.
METHODS
In pediatric allergy clinic of Hanyang University Hospital, 84 asmatics younger than 24 months of age were included from January 1986 to December 1992, who had no abnormality in the airway. Infantile asthma was diagnosed on the basis of chronic cough, episodic wheezing more than three times and reversibility of clinical symptoms by using inhaled bronchodilators. Forty four asthmatics could have been followed and divided into two groups, symptomatic and resolved by analyzinng their medical records and performing follow- up examination with blood and skin prick tests to common allergens.
RESULTS
1) The two study groups included resolved 28 children (63.6%) and symptomatic 16 children (36.4%) with the ratio of male 3.9 to female 1. 2) There were no significant differences the age of first wheezing episode (9.6+/-5.6 mo. vs. 9.9+/-3.5 mo.) as well as diagnosis (14.3+/-5.7 mo. vs. 16.2+/-5.1 mo.) between two study groups, respectively (P>0.05). 3) For history of atopic dermatitis, there was significant difference between the resolved group 6 of 28 children and the symptomatic group 12 of 16 (P<0.05). 4) For laboratory examination, no significant difference was observed, between the levels of PB eosinophil count (310.4+/-282.2/mm3 vs. 368.1+/-465.9/mm3 at diagnosis; 294.3+/-205.3/mm3 vs. 457.7+/-511.2/mm3 at follow-up) and serum IgE (107.2+/-126.5 IU/ml vs. 157.6+/-246.3IU/ml at diagnosis; 267.3+/-700.5IU/ml vs. 442.6+/-546.0IU/ml at follow-up). 5) The frequency of asthmatic attack per year was 3.3+/-1.6 vs. 3.7+/-1.7; the duration of clinical symptom was 2.6+/-1.4 vs. 5.7+/-2.0 years, respectively. 6) The results of skin prick test showed that more frequent positivity to common inhalants in symptomatic group than in resolved was observed.
CONCLUSIONS
In the long term follow-up for infantile asthma, the resolved 28 of 44 asthmatics were observed. The positive history of atopic dermatitis might be one of the important predictors for their persistent clinical symptoms.