Characterization of childhood onset asthma in the adult asthmatic population

Abstract

Adult asthma is composed of two groups; childhood type in which asthma begins in childhood, and adult type which starts in adult life. To characterize childhood-onset asthma in the adult asthmatic population, we selected 171 patients with asthma who were treated at Hokkaido University Hospital and examined the time of onset, atopic factors (family history of asthma, skin tests, IgE (RIST, RAST], eosinophil counts, and clinical severity. We then compared these factors between childhood type and adult type. Thirty-three patients out of 171 (19.3%) developed asthma during childhood, mostly before the age of 5. The age of onset in the rest of the 138 patients was equally distributed from 20 to 60 years. Asthma rarely begun between 10 and 15 years. In childhood type, 15 of 33 patients (45%) had continuous symptoms from childhood, and 18 of 33 patients (55%) experienced remission of their asthma and recurrence at an adult age. The group with childhood-type asthma was younger than that with adult-type asthma (32.5 +/- 13.9 (SD) and 49.7 +/- 14.2 years (mean +/- SD), respectively, p less than 0.001). There were no significant differences in atopic factors except for a higher incidence of positive skin reaction and high IgE (RAST) score in childhood type than in adult type. Steroid dependent asthma was less frequent in childhood type than in adult type (10.5% and 37.7%, respectively, p less than 0.01). These results suggest that patients with childhood type are younger and have asthma of milder severity, and it is easier to determine specific antigens in childhood type than in adult type.(ABSTRACT TRUNCATED AT 250 WORDS)