Question
How does one evaluate whether a child has outgrown asthma?
This is an important question. It can be a challenge
to differentiate those children who have truly outgrown
their disease from those who have modified their activities
to avoid wheezing. Several forms of childhood wheezing
and asthma can be outgrown. Children who wheeze primarily
with viral infections in infancy ("transient wheezing")
have a good prognosis and tend to outgrow the tendency
to wheeze by the time they start elementary school.[1]
In addition, many school-aged children have reduced
symptoms or remission upon entering adolescence. However,
teenaged children may attempt to minimize their symptoms,
or even ignore them. Furthermore, some children will
stop exercising in an attempt to prevent one of the
major causes of acute symptoms.
Taking an accurate history is of great importance
in evaluating these 2 possibilities. The focus should
be to determine whether there is cough, wheezing,
or shortness of breath at night, during exercise,
and during upper respiratory infections. Be sure to
ask whether the patient is still exercising: "I
don't wheeze with exercise" could mean that troublesome
asthma symptoms led the patient to stop exercising.
In addition to interviewing the adolescent children,
it is important to get the parents' perspective in
order to obtain an accurate picture of respiratory
symptoms.
Pulmonary function testing is another valuable source
of information about the cessation of asthma. In the
interpretation of spirometry, the ratio of the forced
expiratory volume in 1 second (FEV1) to the forced
vital capacity (FVC) appears to be the most sensitive
measure of persistent asthma.[2] It is important to
realize, however, that during asymptomatic periods,
lung function tests can be normal in intermittent
and mild persistent asthma.
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covers all uses, directions, drug interactions, precautions, or adverse
effects of your medication. This is only general information, and should
not be relied on for any purpose, it should not be construed as containing
specific instructions for any particular patient. Simplerx.com disclaims
all responsibility for the accuracy of, and reliability of this information,
and or any consequences arising from the use of this information, including
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