ABSTRACT
Advances in asthma clinical assessment help in categorizing patients based on their clinical severity. Eosinophilia is a common laboratory finding in asthmatics. This paper explores the correlation between the clinical severity of asthmatic children and the degree of total peripheral eosinophil count (TPEC). Eighty asthmatic children referred to pediatric and allergy clinics were selected. Their clinical severity levels were assessed using the recent Global Strategy for Asthma Management and Prevention guidelines. Absolute TPEC was performed for all cases by the Cell-Dyne 3500 automated hematology counter. Correlation between clinical severity and TPEC was measured and their means in each severity group were compared for any significant association. Asthmatic children aged between 6 months and 15 years (mean = 5.9 years; 67.5% male) were studied. The clinical severity of their bronchial asthma was divided into four groups: intermittent (6, or 7.5%), mild-persistent (48, or 60%), moderate persistent (20, or 25%), and severe-persistent (6, or 7.5%). TPEC for the groups ranged between 10 and 2100 cells/mm3 (mean = 581.7 cells) and showed a very significant positive correlation with increased asthma severity (R = 0.61, p<0.001). A high linear trend of TPEC within each clinical group was found (F = 51.3, p<0.0001), and the means among each group also showed a significant increase as asthma severity level increased (F = 19.98, p<0.001). The study documents a significant positive correlation between the clinical severity of bronchial asthma and eosinophil counts. The authors advocate the use of this simple and sensitive laboratory test as a significant adjunct objective technique in the assessment of asthma severity and management.
Subject(s)
Asthma/diagnosis , Eosinophils , Asthma/blood , Case-Control Studies , Child, Preschool , Eosinophilia/diagnosis , Female , Humans , Leukocyte Count/instrumentation , Male , Prospective Studies , Severity of Illness IndexABSTRACT
BACKGROUND: Recent asthma guidelines recommend the assessment of severity levels based on the most severe symptoms and peak expiratory flow rate (PEFR). Discrepancies are frequently encountered in the use of these variables in determining the severity levels of asthmatics. The objective of this study was to determine the difference in asthma severity levels as assessed by either symptoms alone or by PEFR alone, as compared with the assessment by the asthma guidelines. PATIENTS AND METHODS: Severity levels that were determined by recent asthma guidelines for 60 asthmatic patients were reassessed, based on symptoms alone and PEFR alone. They were compared for any significant differences to the asthma guidelines. RESULTS: Asthmatics were aged between 15 and 70 (mean 34) years, and 63.8% were females. Severity levels by symptoms alone were different from the guidelines in 27 cases (45%). Of these, 89% showed a tendency toward higher severity levels. Severity levels by PEFR alone were different in only three cases (5%). In both comparisons, differences of severity levels were significant (P<0.0001), but assessment by symptoms alone showed more deviation (x(2) =162.1) than PEFR alone (x(2) =73.1). CONCLUSION: The study documented significant discrepancies in asthma severity assessed by symptoms alone and PEFR alone, when compared to the recent asthma guidelines. Severity assessed by symptoms alone showed lower levels, and the use of PEFR tended to categorize some asthmatics into a more severe level.
ABSTRACT
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