scholarly journals Characterization of severe asthma in the pediatric population

2021 ◽  
Vol 49 (2) ◽  
pp. 60-65
Author(s):  
Amalui Vasquez Perez ◽  
Anna Bobé Pol ◽  
Elizabeth Rua Hernandez ◽  
Marc García Lorenzo ◽  
Alba Gomez Serra ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Lung Function ◽  
Severe Asthma ◽  
Hospital Admissions ◽  
Age Of Onset ◽  
Pediatric Population ◽  
Heavy Traffic ◽  
Control Device ◽  
Predictive Index ◽  
Medical Histories

Introduction and objectives: Relationship between the causal mechanisms of pediatric severe asthma and severity of symptoms would be helpful for developing personalized strategies for treatment and prevention.Materials and methods: For this study, 698 medical histories of asthmatics between 6 and 18 years of age were reviewed in a period of 2 years. Variables analyzed were: age, sex, ethnicity, perinatological history, allergy history, asthma predictive index (API), exposure to tobacco, heavy traffic or epithelium, lung function, age of onset of symptoms, hospitalization admissions/PICU, systemic corticosteroids, daily symptoms control, device prescribe for daily control, and adherence.Results: A total of 86 children with severe asthma were included (12.3%). Mean age 13.3 +/− 1.86 years, sex ratio1:1, mean age of symptom onset 2.765 +/− 3.06 years, mean IgE 1076.18KU / L +/− 1136, mean eosinophils 604c / mcl +/− 511.9, mean of FEV1 93.15% +/− 16.3. Evidently, 70 children (81.4%) had positive API, 68 (79.1%) rhinitis, 34 (39.5%) atopic dermatitis. 73 (83.9%) sensitized to inhalants and 56 (65.1%) to dermatophagoides, 39 (45.3%) passive smokers, 19 (22.1%) exposure to heavy traffic; 55 (64%) showed symptoms with exercise, 35 (40.7%) had audible wheezing. The mean systemic corticosteroid cycles/year was 3.63 +/− 3.23, mean PICU admissions 0.36 +/− 0.83, mean hospital admissions 4.31 +/− 5.3, average emergency room visits/year 19.44 +/− 16.28. 38 (56.7%) had good adherence, 44 (51%) used an MDI device and 39 (45.3%) used dry powder.Conclusions: Children with severe asthma meet the following criteria: premature, positive API, rhinitis, atopic dermatitis, high IgE, eosinophilia, passive smokers, exposure to heavy traffic, decreased lung function, and low adherence to controller medication.

Dupilumab Effect on Lung Function in Patients with Uncontrolled, Moderate-to-Severe Asthma with an Allergic Phenotype

2020 ◽  
Author(s):  
M Castro ◽  
J Corren ◽  
TB Casale ◽  
S Quirce ◽  
MS Rice ◽  
...  
Keyword(s):  
Lung Function ◽  
Severe Asthma

Identifying problematic severe asthma in the individual child - does lung function matter?

2010 ◽  
Vol 99 (3) ◽  
pp. 404-410 ◽  
Author(s):  
AM Lang ◽  
J Konradsen ◽  
K-H Carlsen ◽  
C Sachs-Olsen ◽  
P Mowinckel ◽  
...  
Keyword(s):  
Lung Function ◽  
Severe Asthma ◽  
Individual Child ◽  
The Individual

Molecular pathogenesis and clinical implications of eczema herpeticum

2008 ◽  
Vol 10 ◽  
Author(s):  
Caroline Bussmann ◽  
Wen-Ming Peng ◽  
Thomas Bieber ◽  
Natalija Novak
Keyword(s):  
Atopic Dermatitis ◽  
Age Of Onset ◽  
Current Knowledge ◽  
Allergen Challenge ◽  
Skin Lesions ◽  
Molecular Pathogenesis ◽  
Type I Interferons ◽  
Total Serum ◽  
Type I ◽  
Eczema Herpeticum

A subgroup of patients with atopic dermatitis develops one or more episodes of a severe viral skin infection caused by herpes simplex virus superimposed on eczematous skin lesions. This condition is named atopic dermatitis complicated by eczema herpeticum. Characteristic features of patients developing eczema herpeticum include an early age of onset of atopic dermatitis with a persistent and severe course into adulthood, predilection for eczematous skin lesions in the head and neck area, elevated total serum IgE levels and increased allergen sensitisation. Deficiencies at the level of both the innate and the adaptive immune system, which have been identified in atopic dermatitis, are much more pronounced in this subgroup. Predisposing cellular factors include a reduced number of plasmacytoid dendritic cells in the epidermis and a modified capacity of these cells to produce type I interferons after allergen challenge. In addition, lower levels of antimicrobial peptides in the skin of atopic dermatitis patients, resulting in part from a Th2-prone micromilieu, contribute to the lack of an effective defence against viral attack. In this review, we summarise the current knowledge of the molecular pathogenesis of eczema herpeticum.

No association between vitamin D and atopy, asthma, lung function or atopic dermatitis: a prospective study in adults

Allergy ◽  
2015 ◽  
Vol 70 (11) ◽  
pp. 1501-1504 ◽  
Author(s):  
B. H. Thuesen ◽  
N. G. Heede ◽  
L. Tang ◽  
T. Skaaby ◽  
J. P. Thyssen ◽  
...  
Keyword(s):  
Vitamin D ◽  
Atopic Dermatitis ◽  
Lung Function ◽  
Prospective Study ◽  
A Prospective Study

scholarly journals Substantiation of Using Pimecrolimus 1% Cream in Proactive Therapy of Children with Atopic Dermatitis

2021 ◽  
Vol 20 (5) ◽  
pp. 376-382
Author(s):  
Nikolay N. Murashkin ◽  
Roman A. Ivanov ◽  
Eduard T. Ambarchian ◽  
Roman V. Epishev ◽  
Alexander I. Materikin ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Maintenance Therapy ◽  
Skin Disease ◽  
Pediatric Population ◽  
Efficacy And Safety ◽  
Inflammatory Skin Disease ◽  
High Prevalence ◽  
Proactive Therapy ◽  
Term Maintenance

Atopic dermatitis (AtD) is multifactorial inflammatory skin disease with high prevalence in pediatric population. It is crucial to implement long-term maintenance therapy to prevent AtD exacerbations according to current clinical guidelines and expert reports. The article summarizes the results of the major studies on using pimecrolimus 1% cream. Its efficacy and safety in long-term proactive therapy of children with AtD are presented.

Clinical and molecular spectrum associated with Polymerase-γ related disorders

2022 ◽  
pp. 088307382110670
Author(s):  
Ruchika Jha ◽  
Harshkumar Patel ◽  
Rachana Dubey ◽  
Jyotindra N. Goswami ◽  
Chandana Bhagwat ◽  
...  
Keyword(s):  
Age Of Onset ◽  
Pediatric Population ◽  
Single Gene ◽  
Management Strategies ◽  
Clinical Manifestations ◽  
Progressive External Ophthalmoplegia ◽  
Leigh Disease ◽  
Pathogenic Variants ◽  
Phenotype Analysis

Background POLG pathogenic variants are the commonest single-gene cause of inherited mitochondrial disease. However, the data on clinicogenetic associations in POLG-related disorders are sparse. This study maps the clinicogenetic spectrum of POLG-related disorders in the pediatric population. Methods Individuals were recruited across 6 centers in India. Children diagnosed between January 2015 and August 2020 with pathogenic or likely pathogenic POLG variants and age of onset <15 years were eligible. Phenotypically, patients were categorized into Alpers-Huttenlocher syndrome; myocerebrohepatopathy syndrome; myoclonic epilepsy, myopathy, and sensory ataxia; ataxia-neuropathy spectrum; Leigh disease; and autosomal dominant / recessive progressive external ophthalmoplegia. Results A total of 3729 genetic reports and 4256 hospital records were screened. Twenty-two patients with pathogenic variants were included. Phenotypically, patients were classifiable into Alpers-Huttenlocher syndrome (8/22; 36.4%), progressive external ophthalmoplegia (8/22; 36.4%), Leigh disease (2/22; 9.1%), ataxia-neuropathy spectrum (2/22; 9.1%), and unclassified (2/22; 9.1%). The prominent clinical manifestations included developmental delay (n = 14; 63.7%), neuroregression (n = 14; 63.7%), encephalopathy (n = 11; 50%), epilepsy (n = 11; 50%), ophthalmoplegia (n = 8; 36.4%), and liver dysfunction (n = 8; 36.4%). Forty-four pathogenic variants were identified at 13 loci, and these were clustered at exonuclease (18/44; 40.9%), linker (13/44; 29.5%), polymerase (10/44; 22.7%), and N-terminal domains (3/44; 6.8%). Genotype-phenotype analysis suggested that serious outcomes including neuroregression (odds ratio [OR] 11, 95% CI 2.5, 41), epilepsy (OR 9, 95% CI 2.4, 39), encephalopathy (OR 5.7, 95% CI 1.4, 19), and hepatic dysfunction (OR 4.6, 95% CI 21.3, 15) were associated with at least 1 variant involving linker or polymerase domain. Conclusions We describe the clinical subgroups and their associations with different POLG domains. These can aid in the development of follow-up and management strategies of presymptomatic individuals.

Sign in / Sign up

Export Citation Format

Share Document