[Bronchial asthma in the 2d and 3d year of life]

Abstract

In studying age of onset in our cases of extrinsic asthma, we found that symptomatology occurred in 50% of our patients before the age of 3, and in 45.2% between the first and third year of life. We are therefore concerned about children coming to our service after a long period of illness, since difficulty of recuperation correlates with the duration of asthma. When the onset of asthma is between the first and third years, the child is not yet familiar with his own body's function, and learns how to live as an asthmatic with decreased lung capacity in the intercritic period. As noted by Shepherd, the retention of mucus in a child's lungs will impair the respiratory function more than it does in the adult, since the lesion of an immature structure may hinder its normal development. It is therefore important at this age to maintain respiratory function. 242 children aged between 1 and 3 were studied, who suffered from obstructive respiratory syndromes whose etiology was determined by clinical history and immunoallergic parameters, both "in vivo" and "in vitro". The correlation between the RAST and skin test values by planimetry was also studied. 4 groups were distinguished according to the Foucard score: Group I: consisted of children with a clinical history suggestive of extrinsic allergic asthma due to house dust/mites, with positive skin tests and RAST positive 3-4. Group IIa: also suggestive of extrinsic allergic asthma, with positive clinical history, positive skin test and RAST O. Group IIb: with a positive clinical history, positive skin test and RAST 1-2. Group III: consisted of children with obstructive bronchitis, and uncertain clinical history, negative skin and inhalant tests and RAST O. Group IV: consisted of children with extrinsic asthma due to moulds, with a suggestive clinical history, positive skin tests and RAST 1-2-3-4. Diagnostic methods and therapy in the different groups are discussed. There is a high incidence of onset between the 2nd and 3rd year of age (45%). In the pediatric allergic service the incidence of onset in this age group is only 7.8%. Early diagnosis is essential to avoid damage to lung function in the intercritic period. Difficulty of diagnosis: in the 2nd year we found 38.4% positive and 15.5% suggestive results, totalling 53.9%; and in the 3rd year we found 45.7% positive and 6.2% suggestive results, totalling 51.9%, giving us a more than 50% possibility of extrinsic allergic asthma as the diagnosis.