Diagnosed bronchial asthma in children with known episodes of acute bronchitis at an early age: evidence based on ten years of experience

Though there is a specific national program, guidelines, and international consensus paper, diagnosis of bronchial asthma (BA) in preschoolers is still a challenge for practitioners. The main disease to be distinguished from BA is acute bronchitis (AB). Aim. To determine the age of diagnosis of bronchial asthma for children with known episodes of acute bronchitis at an early age and to find out clinical/laboratory features of bronchial asthma in such patients. Materials and Methods. The research involved 72 children with a history of AB who were divided into 2 groups. The average age of children was 3.2 ± 1.3, the number of known episodes of obstructive bronchitis in past medical history was - 2.0 [1.0-3.0] (Me; 25-75 %). Results. Out of 72 children with a history of AB, BA was diagnosed in 32 (44.4 %); 25 of them (78 %) were diagnosed with asthma at the age of 5 or earlier. The analysis of the inflammatory phenotype of induced sputum in children with BA revealed paucigranulocytic type in 4 children (13 %), mixed type in 2 (6 %), and eosinophilic type in 26 (81 %). It was found that children with a history of AB who had a dynamic increase of eosinophil levels in induced sputum by 5% or more, irrespective of the baseline levels of eosinophils in induced sputum, developed bronchial asthma in 95.2 % of cases.