Infants with Suspected Asthma Presenting with Recurrent or Persistent Wheezing

Ahn, So Hyun; Lim, Dae Hyun; Son, Byong Kwan; Kim, Jeong Hee

Abstract

PURPOSE
This study was designed to investigate the characteristics of infants with recurrent or persistent wheezing who present normal chest X-ray.
METHODS
Nonfebrile infants with recurrent or persistent wheezing who revealed normal or only peribronchial infiltration on chest X-rays were enrolled. All infants divided into 2 groups by CT findings: The bronchiolitis or asthma group (hyperinflation or peribronchial wall thickening) and the aspiration pneumonia group (air space consolidation).
RESULTS
The subjects were 30 infants (26 males and 4 females). Their mean age was 6.5+/-3.51 months. CT findings revealed no congenital abnormalities of the airways. There were 22 patients (73.3%) in the bronchiolitis or asthma group and 8 patients (26.3%) in the aspiration pneumonia group. There was no difference in the levels of total IgE and serum eosinophil cationic proteins between the 2 groups (33.9+/-36.78 vs. 39.03+/-39.98/30.87+/-34.73 vs. 48.85+/-44.59, P>0.05). However, the concentration of peripheral eosinophils was significantly higher in the bronchiolitis or asthma group than that of the aspiration pneumonia group (272+/-191.03 vs. 92.25+/-79.33, P=0.012). The results of 24-hr pH monitoring did not show any difference between the 2 groups. During follow-up, 9 of the 20 in the bronchiolitis or asthma group and 4 of the 8 patients in the aspiration pneumonia group were diagnosed with infantile asthma.
CONCLUSION
Aspiration pneumonia should be considered in infants presenting with recurrent or persistent wheezing who show normal X-ray without elevated levels of peripheral eosinophils.