MEDIX, God. 14 Br. 74  •  Stručni članak  •  Dijagnostičko-terapijski postupci u pedijatriji HR ENG

Astma u male djece – dijagnostički pristupAsthma in small children – diagnostic approach

Irena Ivković-Jureković

Iako astma najčešće počinje u predškolskoj dobi, među djecom koja imaju ponavljajuće epizode piskanja do šeste godine života uz astmu se krije i nekoliko drugih fenotipova koji se značajno razlikuju s obzirom na patofiziologiju, čimbenike rizika, prognozu i liječenje. Svako dijete koje ima recidivno piskanje zahtijeva individualan pristup. Potrebna je detaljna anamneza i fizikalni pregled te dijagnostička obrada kojom se isključuju mogući uzroci recidivnog piskanja. Prolazno rano piskanje i neatopijsko virusima izazvano piskanje imaju dobru prognozu i uz simptomatsko liječenje prestaju do polaska u školu. Međutim, u djece koja boluju od astme proces remodeliranja koji dovodi do ireverzibilnih promjena u strukturi bronha i propadanja plućne funkcije prisutan je od početka bolesti. Kod njih je osobito važno rano postaviti dijagnozu radi pravovremenog uvođenja protuupalnog liječenja 

Ključne riječi:
mala djeca, ponavljajuće piskanje, astma, dijagnoza

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 14 Br. 74

Although asthma starts most often at a pre-school age, among the children who have recurrent episodes of wheezing there are several other phenotypes that differ significantly regarding the pathophysiology, risk factors, prognosis and treatment. Each child with a history of recurrent wheezing requires an individual approach. This involves recording a detailed medical history and a thorough physical examination, as well as other diagnostic procedures to exclude possible causes of recurrent wheezing. Both the transient early wheezing and non-atopic viral induced wheezing have a good prognosis and, with symptomatic treatment, cease before the school age. However, the process of remodeling which causes irreversible changes in the bronchial structure is present from the very beginning in children who suffer from asthma. It is therefore particularly important to determine an early diagnosis in these children, in order to introduce .anti-inflammatory treatment on time. 

Key words:
small children, recurrent wheezing, asthma, diagnosis