Intensity of bronchial hyperresponsiveness and asthma relapse risk in the young adult

Abstract

Background The evolution of asthma starting in childhood varies and depends on a series of factors (atopy, allergens, and environmental irritants, etc). Treatment may influence the evolution of the disease and even cause the symptoms to disappear. However, there remains a risk of relapse years later. Objectives To assess the role of bronchial hyperresponsiveness in asthma relapse in young adulthood in patients with symptoms that disappeared after treatment prescribed in childhood. Material and methods To determine the evolution of asthma and patients’ personal opinions, 78 patients were sent a questionnaire several years after having been discharged without symptoms in the previous 2 years, and without the need for medication. The methacholine test was used to evaluate bronchial hyperresponsiveness at discharge. The 40 patients who correctly completed the questionnaire were divided into three groups according to the methacholine dose required to obtain a 20 % decrease in forced expiratory volume in 1 second (PD20): group 1 (15 patients), < 1000 μg; group 2 (10 patients) between 1001 and 2000 μg; and group 3 (15 patients) > 2100 μg. The mean age at discharge was 16 years (range 13-25 years) versus 26 years at the time of response (range 18-33 years), with a similar distribution in all three groups. Age at disease onset, with estimation of severity, age at the first visit and at the start of treatment, and respiratory function were evaluated. Results Thirty of the interviewed patients considered themselves to be cured. Seven of the patients (three in group 1, one in group 2, and three in group 3) did not consider themselves to be cured, although their symptoms were minimal and they rarely used medication. Health status was described as “regular” with sporadic symptoms by one patient in each group. No correlation with methacholine response was observed. Conclusion No relationship was found between the degree of bronchial hyperresponsiveness and the risk of relapse in young adults who suffered asthma in childhood.