An algorithm for the diagnosis of asthma in children
Asthma should not be equated to wheeze alone, nor to indiscriminate respiratory symptoms because of coincidental positive allergy findings. This article offers an approach to the diagnosis of asthma in children based on the assumption that asthma in children is a chronic allergy-driven eosinophilic inflammation with consequent functional and clinical alterations that turn the affected individual into a patient with potentially chronic and measurable respiratory impairment and predictable therapeutic response to the currently recommended schemes of controller and reliever asthma medications. Other conditions, that are often called „asthma“, and should, rather, be described in terms of a „wheezy syndrome“, with various, mainly age dependent attributes, are considered to form the differential diagnosis of asthma. The algorithm is conceived as a series of binary decision steps that could be completed within one work-day in a medium equipped pediataric allergy and pulmonology outpatient clinic upon seeing for he first time a child with current .or anamnestic wheeze, dry cough, dyspnea, or chest tightness.
Key words:
asthma, child, lung function test, allergy work-up, methacholine bronchial challenge test
OGLASI
