학동기 기침형 천식 환아에서 천명의 발병에 미치는 인자
Factors Associated with the Development of Wheezing in Late Childhood with Cough-Variant Asthma
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Background: Cough-variant asthma (CVA) is a phenotype of asthma solely presenting with persistent cough. It shares several features of classic asthma (CA) with wheezing including atopy, bronchial hyperresponsiveness (BHR) and eosinophilic airway responsiveness. Objective: To compare these features between CVA and CA and to know the development of wheezing in CVA. Method: Ninety-two children with CVA were enrolled and evaluated every 3 months for 5 years. At study initiation, the skin prick test, BHR to methacholine and induced sputum analysis were performed and compared with 45 CA children. Children with CVA were divided into 2 groups according to the development of wheezing: patients who did not develop wheezing (Group A) and those who developed wheezing (Group B). Result: Children with CA had higher rates of sensitization to house dust mite (HDM), BHR, eosinophil cationic protein (ECP) level and eosinophil percentage in induced sputum than those with CVA. Wheezing developed in 45 (48.9%) of the 92 children with CVA. Development of wheezing in CVA was associated with sensitization to HDM, ECP level and eosinophil percentage in induced sputum, but not BHR. Conclusion: Atopy and eosinophilic airway inflammation is possible in children with CVA and these findings may be related to the development of wheezing in those with CVA.
Abstract
Background: Cough-variant asthma (CVA) is a phenotype of asthma solely presenting with persistent cough. It shares several features of classic asthma (CA) with wheezing including atopy, bronchial hyperresponsiveness (BHR) and eosinophilic airway responsiveness. Objective: To compare these features between CVA and CA and to know the development of wheezing in CVA. Method: Ninety-two children with CVA were enrolled and evaluated every 3 months for 5 years. At study initiation, the skin prick test, BHR to methacholine and induced sputum analysis were performed and compared with 45 CA children. Children with CVA were divided into 2 groups according to the development of wheezing: patients who did not develop wheezing (Group A) and those who developed wheezing (Group B). Result: Children with CA had higher rates of sensitization to house dust mite (HDM), BHR, eosinophil cationic protein (ECP) level and eosinophil percentage in induced sputum than those with CVA. Wheezing developed in 45 (48.9%) of the 92 children with CVA. Development of wheezing in CVA was associated with sensitization to HDM, ECP level and eosinophil percentage in induced sputum, but not BHR. Conclusion: Atopy and eosinophilic airway inflammation is possible in children with CVA and these findings may be related to the development of wheezing in those with CVA.
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