Diagnosis and therapy in pre-school children with asthma or asthma-like symptoms

Abstract

Diagnosing asthma in pre-school children with asthma or asthma-like symptoms is a major problem because of the similarity of the symptoms. The initial treatment of these young patients is often performed by general practitioners. Currently very much attention is paid to the use of inhalation corticosteroids (ICS) in these young children while optimal treatment regiments are still unclear. The precise place of ICS has yet to be clarified in children with recurrent wheezing. Although several studies have shown that ICS is effective in the treatment of asthma we do not know which of these children should be given maintenance therapy with inhaled corticosteroids and which not.Only a small percentage of early wheezers go on to develop classic asthma. It is possible that children with transient wheeze do not respond to ICS in the same way true asthmatics do. The ability to predict accurately those wheezy pre-school children who will develop asthma eludes us. To focus on these diagnostic and therapeutic dilemmas. A multicentre, parallel group, randomised, double blind study to investigate the efficacy of ICS in 1 to 5 year old children with asthma or asthma-like symptoms. Study population: children with asthma or asthma-like symptoms in which in normal daily practice the general practitioner considers treatment with ICS because of symptoms. In this study we try to answer the question which children will benefit from maintenance treatment with ICS; as part of this study we have developed an Asthma Diagnostic Questionnaire. By using this questionnaire and by collecting additional lung function data (Forced Oscillation Technique and Resistance Interrupter Technique) we try to distinguish children with probably asthma from children with probably non-asthma. The results of our study may lead to an improvement in the diagnosis and treatment of asthma or asthma-like symptoms in pre-school children.