Characteristics of Childhood Asthma According to the Onset of Wheezing

Kim, Yoon Jeong; Kim, Bong Seong; Hong, Soo Jong

Abstract

PURPOSE: To understand the characteristics of early childhood asthma, we evaluated and compared the characteristics between early persistent wheezers and late wheezers.
METHODS
From January, 1998 to December, 1998, 106 children aged six to seven years were divided into three groups according to the onset of wheezing:Early persistent wheezers (n=36) who had wheezing both before three years of age and at six, late wheezers (n=48) who had no wheezing before the age of three years but had wheezing at six years, and control group (n=22) who had never wheezed at the age of six years. We performed pulmonary function and methacholine challenge tests, and measured the concentration of serum total IgE, D. pteronyssinus & D. farinae-specific IgE and total eosinophil count in these children.
RESULTS
Early persistent wheezers had significantly diminished FEF25-75% than late wheezers and control group. Both early persistent wheezers and late wheezers had airway hyperresponsiveness to methacholine. Late wheezers had higher concentrations of serum total IgE than control group. The concentration of D. pteronyssinus and D. farinae-specific IgE and total eosinophil count were elevated significantly in early persistent wheezers and late wheezers than control group.
CONCLUSION
Late wheezers are more closely related to atopy. Early persistent wheezers have diminished FEF25-75%, suggesting that early persistent wheezers may have abnormalities of peripheral airway. Therefore, these results strongly suggest that wheezing during childhood may be a heterogenous condition and there are apparently different two groups, early persistent wheezers and late onset wheezers, in childhood asthma.