Asthma in infancy and early childhood pitfalls in diagnosis

ABSTRACT

Bronchial asthma is well known to be the commonest cause of wheezing in infancy and early childhood. Over as well as under-diagnosing asthma may be hazardous. The study included 300 wheezy infants and children aged 3 months to 4 years referred by pediatricians and general practitioners for further management of asthma. From a detailed history, clinical and radiological examination and immunological investigations in some cases we could reach a provisional diagnosis. Immunological investigations included humoral immunoglobulins and T- cell functions in suspected cases of immunodeficiency. Follow up for 2-3 years showed that only 30 percent of the patients proved to be asthmatics. Wheezy bronchitis following an upper respiratory viral infection occurred in about 50 percent of cases. Acute bronchiolitis could be diagnosed in 2 percent, most of which were hospitalized. About 8 percent of the cases had foreign body inhalation which was extracted by bronchoscopy. Immunodeficiency, mainly humoral though sometimes combined, could be diagnosed in 7 percent of cases. Other less common causes as tuberculous hilar nodes, cardiomyopathy and congenital anomalies were diagnosed in about 3 percent of cases