Bronchial asthma evolution in children within 3 years from the diagnosis

Abstract

Introduction. The natural history of bronchial asthma (BA) in newly diagnosed children is not well understood.Objective. To determine the trends in the course of mild BA in children over 3 years from the date of initial diagnosis.Materials and methods. A prospective controlled study included 149 children (106 boys, 43 girls) aged 5 years to 5 years 11 months with mild BA diagnosed less than 1 year ago. During a 3-year follow-up, the severity of BA, the need for basic and emergency therapy were assessed. An increase in therapy and the severity of BA was regarded as progression of the disease; the spectrum and extension of sensitization to inhaled allergens were taken into account.Results and discussion. Of 149 children with persistent asthma, 103 were sensitized to one or more household allergens, most frequently to cat (36.2% in the cohort) and dust mites (30.9%). During 3 years of follow-up, the patients did not develop a stable remission of BA with the possibility of canceling basic therapy for more than 6 months in a row. In children receiving basic therapy, it is typical (up to 71% of cases) that the need for therapy remains, or the volume of therapy increases (up to 27% of cases). In children who initially did not receive basic therapy, an increase in therapy is typical (63% of cases). Disease progression was noted over 3 years of follow-up in 70 (47%) patients, most often in the group who initially did not receive basic therapy (73.5%) as well as among children with polysensitization to household allergens (88.9%).Conclusion. Dynamic observation of preschool age patients with BA shows a tendency to persistence or progression of the disease in the first 3 years from the diagnosis.