A Clinical Study on Infantile Asthma

Kim, Myung Sung

Abstract

PURPOSE
Early diagnosis and treatment of infantile asthma is very important because early treatment might influence the long term outcome. Tabachnik and Levison proposed in 1981 that "any infant with three or more episodes of wheezing should be considered as having asthma, regardless of the age of onset, evidence of atopy, apparent precipitating cause of wheeze." So we conducted clinical study in infants (less than 2 yr of age) with three or more episodes of wheezing. Method : 69 infants less than 2 yr of age with three or more episodes of wheezing admitted to the Department of Pediatrics, Keimyung University, Dongsan Medical Center from January, 1993 to December, 1994 were investigated for their chief complaint, allergic history, physical examination, serum IgE, MAST(multiple antigen simultaneous test), severity of asthma, response to bronchodilator and outcome after 3 yrs.
RESULTS
The male to female ratio was 3.6:1. In age distribution, 60.8% of infants with asthma was less than 12 month. The Serum level of total eosinophil count and total IgE was mostly within normal limit, and only 5 of 30 cases performed MAST were positive. In chest radiologic finding, hyperinflation was most common(65.2%) and increased bronchovascular marking, pneumonia in orders. In the severity of asthmatic attack according to age on diagnosis, infants with asthma less than 12 month of age showed more severe than over than 13 month of age. In the responsiveness to bronchodilator therapy, infants with asthma less than 12 month of age showed poorer response than over than 13 month of age. In the outcome of 69 infantile asthma after 3 yrs, the patients of infantile asthma with atopy showed poorer prognosis than without atopy.
CONCLUSIONS
In the diagnosis of infantile asthma, three or more episodes of wheezing and/or allergic history was more important than laboratory and allergic test. Because infants with asthma less than 12 month of age showed more severe asthmatic attack and poorer response to bronchodilator therapy than over than 13 month of age, it is very important to apply nebulized corticosteroid to them earlier. In the outcome of 69 infantile asthma after 3 yrs, the patients of infantile asthma with atopy showed poorer prognosis than without atopy.