Prévalence de l’asthme éosinophilique dans la population asthmatique pédiatrique lors du diagnostic d’asthme léger à modéré

Abstract

In children, the etiology of asthma is multifactorial and the prevalence of eosinophilic asthma remains poorly understood. AimEstimating the prevalence of eosinophilic asthma among the pediatric asthmatic population when diagnosed with mild to moderate asthma, and comparing the outcome of the exhaled fraction of nitric oxide (FeNO) and allergic skin tests to eosinophilia. MethodsSeventy children aged 5 to 18 years, consulting for the first time for asthma symptoms without treatment, were included. Each patient underwent a medical history, physical examination, allergic skin tests, lung function tests, measurement of the exhaled fraction of nitric oxide and biology with blood count and specific IgE. ResultsAn eosinophilic asthma prevalence of 37% has been found in our population. Eosinophilia ≥ 400/mm3 was correlated with FeNO ≥ 20ppm (≥ 25ppm in children ≥ 12 years old) (p<0.001) and allergic sensitization (p=0.002). Sixty-nine percent (18/26) of patients with eosinophilia ≥ 400/mm3 had FeNO ≥ 20ppm (≥ 25ppm in children ≥ 12 years old) and eighty-eight percent (23/26) had at least one allergic sensitization. Eosinophilia was significantly higher when FeNO was ≥ 20ppm (≥ 25ppm in children ≥ 12 years old) (p<0.001) and during an allergic sensitization (p=0.004). ConclusionOur study confirms the link between 3 markers of Th2-type inflammation: eosinophilia, allergic skin tests positivity and FeNO elevation, to be confirmed by larger studies.