Document Detail


Lack of eosinophilia can predict remission in wheezy infants?
MedLine Citation:
PMID:  18325032     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Early wheezing in infants is a potential risk factor for persistence of asthma into adulthood. Moreover, a personal or familial history of atopy are risk factors associated with persistence of pre-existing wheezing during childhood. However, their relative importance remains unclear. OBJECTIVES: Firstly to determine the critical thresholds of common biological markers of atopy in wheezy infants associated with persistence of wheezing into childhood and secondly to rank these biological markers together with clinical parameters according to the strength of their association with wheezing persistence. METHODS: A cohort of infants less than 30 months old with recurrent wheezing was established in order to assess severity of respiratory symptoms and to look for the presence of atopy. At the age of 6 years, they were re-evaluated regarding remission of wheezing over the previous 12-months period. RESULTS: Data were available for 219 subjects. In 27% of them, wheezing persisted at 6 years of age. Critical biological thresholds associated with the risk of wheezing persistence were: (1) a blood eosinophilia count >or=470/mm(3) (defining eosinophilia), and (2) a total serum IgE level >or=45 IU/mL (defining elevated IgE) during infancy. A multiple component factorial analysis identified a dimension associating eosinophilia, elevated IgE and allergic sensitization on the one hand with persistent wheezing at 6 years of age on the other (lambda=0.15). According to a segmentation analysis, the main discriminative parameter of wheezing persistence was eosinophilia. Thus a lack of eosinophilia alone could account for 91% of infants in remission, and when combined with absence of allergic sensitization, remission was correctly discriminated in 96.9% of the study population. CONCLUSION: Our data strongly suggest that the lack of eosinophilia in wheezy infants without ongoing infection could predict future remission of wheezing in a large majority of cases.
Authors:
J Just; N Nicoloyanis; M Chauvin; C Pribil; A Grimfeld; G Duru
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-03-04
Journal Detail:
Title:  Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology     Volume:  38     ISSN:  1365-2222     ISO Abbreviation:  Clin. Exp. Allergy     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-18     Completed Date:  2008-06-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8906443     Medline TA:  Clin Exp Allergy     Country:  England    
Other Details:
Languages:  eng     Pagination:  767-73     Citation Subset:  IM    
Affiliation:
Centre de l'Asthme et des Allergies, Groupe Hospitalier Trousseau-La Roche Guyon, Assistance Publique, Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France. jocelyne.just@trs.aphp.fr
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MeSH Terms
Descriptor/Qualifier:
Child
Child, Preschool
Cohort Studies
Eosinophilia*
Female
Humans
Hypersensitivity, Immediate / physiopathology
Infant
Infant, Newborn
Male
Predictive Value of Tests
Respiratory Sounds / diagnosis*,  physiopathology*
Risk Factors
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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