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 Vol. 18 No. 1, July 2007
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AAP Grand Rounds 18:6-7 (2007)
© 2007 American Academy of Pediatrics

ALLERGY/IMMUNOLOGY

Analysis of Steroid Treatment of First Wheezing Episode

Source: Lehtinen P, Ruohola A, Vanto T, et al. Prednisolone reduces recurrent wheezing after a first wheezing episode associated with rhinovirus infection or eczema. J Allergy Clin Immunol. 2007;119:570–575; doi:10.1016/j.jaci.2006/11/003[CrossRef][Medline]

The first 20% of the full text of this article appears below.

Acute wheezing affects one-third of children before three years of age, more than one-third of whom have recurrent episodes until age six.1 Viral respiratory infections are a major trigger for acute wheezing episodes in young children.2 Respiratory syncytial virus (RSV)-induced wheeze is followed by recurrent wheezing in one- to two-thirds of infants and, by school age, asthma in about half as many.3,4 The rates of recurrent wheezing following other respiratory viral illnesses are less well established.5 The authors of this Finnish study sought to determine risk factors for recurrent wheezing and to determine the long-term effects of prednisolone treatment on the risk groups.

The authors prospectively enrolled a cohort of children aged 3–35 months who required hospitalization for their first episode of wheezing. Children treated with oral or inhaled corticosteroids in the four weeks preceding enrollment, children with chronic disease, and those who required intensive care treatment were excluded. On admission, comprehensive viral testing (culture, antigen detection, PCR, and/or pre/post illness serology) was performed to identify the presence of RSV, rhinovirus, and six other common respiratory virus species. Total blood eosinophil counts . . . [Full Text of this Article]

Mitchell R. Lester, MD, FAAP
Fairfield County Allergy, Asthma, and Immunology Associates, Norwalk, CT