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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Just, Jocelyne Gouvis-Echraghi, Rahele Couderc, Remy Guillemot-Lambert, Nathalie Saint-Pierre, Philippe |
| Description | Country affiliation: France Author Affiliation: Just J ( Centre de l'Asthme et des Allergies, Groupe Hospitalier Trousseau-La Roche Guyon, University Paris 06, Paris, France. jocelyne.just@trs.aphp.fr) |
| Abstract | BACKGROUND: Recurrent wheezing during infancy is a heterogeneous disorder that has been associated with early-onset asthma. OBJECTIVE: To identify phenotypes of severe recurrent wheezing and therapeutic approaches. METHODS: We performed cluster analysis with 20 variables of 551 children with active asthma, younger than 36 months old, and enrolled in the Trousseau Asthma Program. RESULTS: We identified 3 independent clusters of children with wheezing. Cluster 1, mild episodic viral wheeze (n= 327), consisted of children with wheezing related only to colds (71%), mild disease (76%), and mainly normal chest x-ray results. Cluster 2, nonatopic uncontrolled wheeze (n = 157), was characterized by moderate to severe disease (91%), uncontrolled wheezing despite high doses of inhaled corticosteroids (55%), parents with asthma, and increased levels of ferritine. Cluster 3, atopic multiple-trigger wheeze (n = 67), included more children with multiple-trigger wheeze (68%) than did clusters 1 or 2; eczema (75%); a positive result from the Phadiatop Infant test (90%); increased levels of IgE, IgA, and IgG; and abnormal results from chest x-rays. In separate analysis, 1 parameter for boys (increased total level of IgE) and 2 parameters for girls (wheezing severity and increased total level of IgE) properly classified 90% of boys and 83% of girls in the appropriate cluster. Significant associations were found between overcrowding, molds and cockroaches at home, and atopic multiple-trigger wheeze and between day-care attendance and nonatopic uncontrolled wheeze in other parts. CONCLUSION: We identified different phenotypes of recurrent wheezing in young children by using cluster analysis with usual variables. These phenotypes require confirmation in longer, follow-up studies. |
| File Format | HTM / HTML |
| ISSN | 00916749 |
| e-ISSN | 10976825 |
| Journal | Journal of Allergy and Clinical Immunology |
| Issue Number | 1 |
| Volume Number | 130 |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2012-07-01 |
| Publisher Place | United States |
| Access Restriction | Open |
| Subject Keyword | Discipline Immunology Asthma Physiopathology Hypersensitivity, Immediate Respiratory Sounds Severity Of Illness Index Adrenal Cortex Hormones Therapeutic Use Age Of Onset Anti-asthmatic Agents Drug Therapy Etiology Child, Preschool Cluster Analysis Immunoglobulin E Blood Infant Phenotype Risk Factors |
| Content Type | Text |
| Resource Type | Article |
| Subject | Immunology and Allergy Immunology |
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