BACKGROUND: : Diagnostic criteria for bronchiolitis are variable. OBJECTIVE: : To study how the risk factors for recurrent wheezing and asthma vary by different definitions of bronchiolitis. METHODS: : Viral etiology and atopic characteristics were studied in 259 hospitalized wheezing children (median age, 14 months; range, 0-36 months). The data were analyzed according to age (<6, <12, <24 and <36 months) and whether they had a history or no history of a previous wheezing episode. Sixteen viruses were detected by conventional and molecular methods. Atopic characteristics included the presence of eczema, specific and total IgE responses, blood eosinophil count, and modified asthma predictive index. RESULTS: : Evidence of respiratory virus infection was found in 93% of the cases and allergic sensitization in 26% of the cases. Rhinovirus infections and atopic characteristics (sensitization, blood eosinophil count, and modified asthma predictive index) increased by age and were significantly more common in children with recurrent wheezing episodes than in first-time wheezers in age categories of <24 and <36 months (P < 0.05 for all). CONCLUSIONS: : In children with bronchiolitis, 2 clinical factors, age and number of previous wheezing episodes, are linked to inflammatory (atopy-related factors) and virologic risk factors of asthma (rhinovirus-associated disease). According to current US and UK guidelines, bronchiolitis includes wheezing children <24 months of age. Our observations suggest that the clinical definition should include only children with their first episode of wheezing.
BACKGROUND: : Diagnostic criteria for bronchiolitis are variable. OBJECTIVE: : To study how the risk factors for recurrent wheezing and asthma vary by different definitions of bronchiolitis. METHODS: : Viral etiology and atopic characteristics were studied in 259 hospitalized wheezingchildren (median age, 14 months; range, 0-36 months). The data were analyzed according to age (<6, <12, <24 and <36 months) and whether they had a history or no history of a previous wheezing episode. Sixteen viruses were detected by conventional and molecular methods. Atopic characteristics included the presence of eczema, specific and total IgE responses, blood eosinophil count, and modified asthma predictive index. RESULTS: : Evidence of respiratory virus infection was found in 93% of the cases and allergic sensitization in 26% of the cases. Rhinovirus infections and atopic characteristics (sensitization, blood eosinophil count, and modified asthma predictive index) increased by age and were significantly more common in children with recurrent wheezing episodes than in first-time wheezers in age categories of <24 and <36 months (P < 0.05 for all). CONCLUSIONS: : In children with bronchiolitis, 2 clinical factors, age and number of previous wheezing episodes, are linked to inflammatory (atopy-related factors) and virologic risk factors of asthma (rhinovirus-associated disease). According to current US and UK guidelines, bronchiolitis includes wheezingchildren <24 months of age. Our observations suggest that the clinical definition should include only children with their first episode of wheezing.
Authors: Amy S Feldman; Yuan He; Martin L Moore; Marc B Hershenson; Tina V Hartert Journal: Am J Respir Crit Care Med Date: 2015-01-01 Impact factor: 21.405
Authors: T Jartti; S Kuneinen; P Lehtinen; V Peltola; T Vuorinen; M Leinonen; O Ruuskanen Journal: Eur J Clin Microbiol Infect Dis Date: 2010-10-13 Impact factor: 3.267
Authors: Jonathan M Mansbach; Pedro A Piedra; Stephen J Teach; Ashley F Sullivan; Tate Forgey; Sunday Clark; Janice A Espinola; Carlos A Camargo Journal: Arch Pediatr Adolesc Med Date: 2012-08
Authors: E Bamberger; I Srugo; B Abu Raya; E Segal; B Chaim; I Kassis; A Kugelman; D Miron Journal: Eur J Clin Microbiol Infect Dis Date: 2012-07-24 Impact factor: 3.267