Wheezing and asthma in young children

INDIANAPOLIS -- The diagnosis of asthma in a young child may well be more challenging to pediatricians than previously appreciated, according to a review of research and clinical experience literature by Howard Eigen, M.D., of the Indiana University School of Medicine and Riley Hospital for Children appearing in the October 2008 issue of Clinical Pediatrics.

"Wheezing can be serious," said Dr. Eigen, the Billie Lou Wood Professor of Pediatrics at the IU School of Medicine and director of pediatric pulmonology and critical care at Riley Hospital. "A comprehensive review of clinical practice and peer reviewed studies show that the difficulty of accurate diagnosis is often underestimated by pediatricians who may link it to a passing cold or other non-serious condition rather than relating it to asthma, a chronic and potentially serious disease."

Dr. Eigen noted in his study that in early childhood asthma is often under recognized and under diagnosed because the symptoms can vary widely and are similar to other common childhood illnesses, including a non-specific cough, flu and bronchitis. Establishing a diagnosis of asthma in young wheezing children also can be challenging for the physician because the type, severity and frequency of asthma symptoms vary widely among children and, sometimes even with an individual child.

The Clinical Pediatrics paper reported that symptoms consistence with asthma in young children include:

• Recurrent wheeze associated with such triggers as viral infection or exercise
• Cough
• Chronic bronchitis
• Recurrent Pneumonia
• Increased bronchial hyper-reactivity, such as cough or wheeze with mild exercise

"These symptoms can also be symptoms of conditions other than asthma so it is important for parents and pediatricians to assess the frequency and patterns of the symptoms, for example if they are seasonal or perennial, if they are episodic versus continuous, or if there is a day versus night variation," said Dr. Eigen.

Asthma is the most common long-term disease of children and its incidence is growing worldwide.

The IU School of Medicine is the second largest medical school in the United States. Riley Hospital is one of the nation's leading centers of excellence in pediatric medicine.