The Long‐term Prognosis of Childhood Asthma in a Predominantly Rural Swedish County

Jönsson, Jakob; J, Bøe; Berlin, E

doi:10.1111/j.1651-2227.1987.tb17270.x

Cited by 19 publications

(5 citation statements)

References 15 publications

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“…Similar to other prospective and retrospective longterm studies, an initial mild asthma and/or a late onset of wheezing were associated with a better outcome (7,(24)(25)(26). This does not contradict the favorable prognosis found in children with wheezing during the first years of life since this heterogeneous group contains a substantial number of subjects who will grow out of their tendency to wheeze before 3-5 years of age and hence are not represented in the present cohort (9, 10).…”

Section: Prognostic Predictorssupporting

confidence: 78%

Prognosis of asthma in children: a cohort study into adulthood

Kjellman

Hesselmar

1994

Acta Paediatrica

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Fifty-six children with asthma, randomly selected from a hospital clinic, were followed prospectively for 15 years from a median age of 9-24 years of age. Four follow-ups were performed and included scoring of the frequency of wheezing, the need for medication, admissions to hospital, spirometry, skin prick tests and RAST to common inhaled allergens, and evaluation of living conditions. One patient died of asthma. The remaining 55 reported for all follow-ups. After the second follow-up at a median age of 13 years, all parameters of severity of asthma showed improvement, which was significant at the last follow-up when all subjects were more than 20 years of age. Only 16% of the subjects had been free from wheezing and medication the year prior to the last follow-up. Approximately 90% of the children had clinical allergies and positive allergy tests to pollens and danders and the majority of children retained both the allergies and the reactivity into adulthood. Reactivity to moulds and mites was less frequent (40% and 31%, respectively) and seemed to decrease in adulthood. Approximately 10% of the subjects developed neither clinical allergies nor reactivity in allergy tests. Children with atopic eczema usually retained their eczema as adults. Frequent wheezing and abnormal spirometry in childhood and early onset of asthma were associated with poorer outcome. The social prognosis was excellent.

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Section: Prognostic Predictorssupporting

confidence: 78%

Prognosis of asthma in children: a cohort study into adulthood

Kjellman

Hesselmar

1994

Acta Paediatrica

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“…Only a third of our patients were completely symptomfree in adulthood, which is equal to the figures in the classical studies of Rackeman and Edwards, and Ryssing from 1952 and 1959, and less than found in some other previous studies [7,9,10). Nevertheless, the follow-up time in our study was shorter than the 20 yrs followed in some studies [5][6][7][8][9][10].…”

Section: Discussioncontrasting

confidence: 46%

“…There are several historical reports on the natural course of childhood asthma [5][6][7][8][9][10]. Many of these studies are retrospective, based on questionnaires, and concerning different types of materials.…”

Section: Discussionmentioning

confidence: 99%

The state of childhood asthma in young adulthood

Kokkonen

Linna²

1993

Eur Respir J

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We investigated whether patients with childhood asthma had improved when reaching adulthood. We also evaluated factors which might influence the course of the disease. The study included a group of 108 asthmatics, diagnosed and monitored throughout childhood at the out-patients clinics of Oulu University Central Hospital. At the age of 20-24 yrs of age they were evaluated for the clinical state of their disease, ventilatory lung function and hyperreactivity of the airways. In the interval 30 (28%) had become totally free of symptoms, whilst 24 (22%) continued to have symptoms weekly, or more often. A quarter of the patients continued to use prophylactic medication, half still suffered from allergic rhinitis, and one third had atopic dermatitis. Skin prick tests showed at least one positive result in 86% of the patients, most often to animal danders. Ventilatory lung function tests showed forced vital capacity (FVC) to be within normal limits, but forced expiratory volume in one second (FEV1)/FVC values less than -2 SD predicted were found in 18%. Forty eight percent of the asthmatics reacted to methacholine at a dose of 0.8 mg or lower, and the degree of airway reactivity showed a significant correlation with the current attack rate. The compliance to treatment of asthma was not adequate, as one third smoked and 81% lacked proper check-ups. Concomitant atopic dermatitis, severe early disease and impaired ventilatory lung function at school age, were observed to be significant risk factors for a severe asthma outcome as a young adult.

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“…147 Whether early age of onset bodes poorly for a baby is debated. There are studies showing a more favorable prognosis, 148 a less favorable prognosis, 149 and no effect on prognosis. 138,139 There is further debate about what role acute viral illness plays in the development of obstructive airways diseases in adulthood.…”

Section: Long-term Outcomementioning

confidence: 99%