| Asthma predictive index in children with recurrent wheezing |
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Joo Young Jang1, Hyo Bin Kim1, So Yeon Lee2, Ja Hyung Kim1, Bong Seong Ki1, Hee Jung Seo1, Soo-Jong Hong1 |
1Department of Pediatrics, Asan Medical Center, College of Medicine, Ulsan University
2Department of Pediatrics, Hallym Medical Center, College of Medicine, Hallym University, Seoul, Kore |
| 반복성 천명을 가진 소아에서 천식 발생 예측 지표의 적용 |
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장주영1, 김효빈1, 이소연2, 김자형1, 김봉성1, 서희정1, 홍수종1 |
1울산대학교 의과대학 서울아산병원 소아과
2한림대학교 의과대학 한강성심병원 소아과 |
Correspondence:
Soo-Jong Hong, Email: sjhong@amc.seoul.kr
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| Abstract |
Purpose
: We compared the asthma predictive index(API) and the modified asthma predictive index (mAPI) of the Tuscon Children's Respiratory Study Group in Korean children with recurrent wheezing. We investigated the atopic profiles and presence of allergen sensitization of each risk group, and ascertained the significant clinical risk factors.
Methods
: Two hundred and sixty two children, who visited for recurrent wheezing from 1998 to 2005, were enrolled and divided into groups by API and mAPI. We investigated the history of the patients and their families, atopic profiles, and sensitization to aeroallergen and food allergens. Twenty nine children were followed up to 6 years of age and we evaluated the sensitivity, specificity and positive and negative predictive value of both indices.
Results
: The high risk group of API were of older age, were more likely to be sensitized to aeroallergen(P=0.001) and food allergen(P=0.034) and had higher levels of total eosinophil count, eosinophil percent, serum ECP, total IgE, and D.p-, D.f-specific IgE. High risk group of mAPI showed higher levels of atopic markers such as egg-, milk-, D.p- and D.f-specific IgE. Even though API did not include allergen sensitization, the high risk group was more significantly sensitized to common allergens than the low risk group. Twenty nine children were followed up until 6 years of age; therefore 15 children were diagnosed as asthma, clinically. The sensitivity, specificity, positive and negative predictive values of mAPI were higher than API.
Conclusion
: Both high risk groups of API and mAPI had higher levels of atopic markers and were more sensitized to common allergens. These findings suggest that sensitization to aeroallergens and food allergens are more objective markers as asthma predictive indices. In addition, mAPI is a more reliable index in predicting asthma in Korean children with recurrent wheezing than is API. But only 29 patients were followed until the age of 6, so we need to include more children with long term follow up for future study. |
| Key Words:
Medulloblastoma , Growth failure , Hypothyroidism , Hypogonadism , Radiation therapy |
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