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Issues in pediatric asthma
Author(s) -
Helms Peter J.
Publication year - 2001
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.2007
Subject(s) - medicine , asthma , intensive care medicine , pediatrics , inhaled corticosteroids , disease , differential diagnosis , population , immunology , pathology , environmental health
Different wheezing syndromes can carry the diagnostic label of “asthma,” especially in very young children, and an accurate differential diagnosis is essential for improving outcomes. Because presenting symptoms are similar, making a rapid, accurate differential diagnosis is often daunting. Asthma can, eventually, be distinguished from other wheezing disorders based on differences in symptomatology, pathophysiology, and disease evolution. Once diagnosed, inhaled corticosteroids (ICS) remain the cornerstone of treatment in persistent pediatric asthma. Compelling evidence supports the benefits of these agents in reducing asthma‐related morbidity and mortality and in preventing airway remodeling. As a result, ICS use in young children with asthma has grown substantially in recent years. Questions are being raised about the appropriateness of early and long‐term use of ICS in young children, and whether ICS are overused in this population. Because of the challenges faced by clinicians in differentiating asthma from the other childhood wheezing disorders often present in young children, it may be best to delay the use of regular ICS therapy until a definitive diagnosis can be established. Alternatives to ICS (such as the leukotriene receptor antagonists) should also be considered to avoid the growth‐suppressing potential of steroids in the management of mild asthma. Pediatr Pulmonol. 2001; Supplement 21:49–56. © 2001 Wiley‐Liss, Inc.