Characterization of severe asthma in the pediatric population

Abstract

Introduction and objectives: Relationship between the causal mechanisms of pediatric severe asthma and severity of symptoms would be helpful for developing personalized strategies for treatment and prevention.

Materials and methods: For this study, 698 medical histories of asthmatics between 6 and 18 years of age were reviewed in a period of 2 years. Variables analyzed were: age, sex, ethnicity, perinatological history, allergy history, asthma predictive index (API), exposure to tobacco, heavy traffic or epithelium, lung function, age of onset of symptoms, hospitalization admissions/PICU, systemic corticosteroids, daily symptoms control, device prescribe for daily control, and adherence.

Results: A total of 86 children with severe asthma were included (12.3%). Mean age 13.3 +/− 1.86 years, sex ratio1:1, mean age of symptom onset 2.765 +/− 3.06 years, mean IgE 1076.18KU / L +/− 1136, mean eosinophils 604c / mcl +/− 511.9, mean of FEV1 93.15% +/− 16.3. Evidently, 70 children (81.4%) had positive API, 68 (79.1%) rhinitis, 34 (39.5%) atopic dermatitis. 73 (83.9%) sensitized to inhalants and 56 (65.1%) to dermatophagoides, 39 (45.3%) passive smokers, 19 (22.1%) exposure to heavy traffic; 55 (64%) showed symptoms with exercise, 35 (40.7%) had audible wheezing. The mean systemic corticosteroid cycles/year was 3.63 +/− 3.23, mean PICU admissions 0.36 +/− 0.83, mean hospital admissions 4.31 +/− 5.3, average emergency room visits/year 19.44 +/− 16.28. 38 (56.7%) had good adherence, 44 (51%) used an MDI device and 39 (45.3%) used dry powder.

Conclusions: Children with severe asthma meet the following criteria: premature, positive API, rhinitis, atopic dermatitis, high IgE, eosinophilia, passive smokers, exposure to heavy traffic, decreased lung function, and low adherence to controller medication.