Please use this identifier to cite or link to this item: http://hdl.handle.net/1959.13/26978

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Title
Airway eosinophilia is associated with wheeze but is uncommon in children with persistent cough and frequent chest colds
Author/Creator
Gibson, Peter G.;  Simpson, Jodie L.;  Chalmers, Anita;  Toneguzzi, Ruth C.;  Wark, Peter A. B.;  Wilson, Amanda J.;  Hensley, Michael J.
Description
The role of eosinophilic airway inflammation in the variant asthma syndromes of cough and chest colds is not well defined. We tested the hypothesis that children with persistent cough and chest colds have increased sputum eosinophils, similar to those with wheeze. The parents of 390 primary school children completed a symptoms questionnaire. Children with wheeze (n = 28), cough (n = 12), recurrent chest colds (n = 17), and no symptoms (control subjects, n = 26), underwent allergy skin prick tests, spirometry, hypertonic saline inhalation challenge, and sputum induction, and then completed a peak expiratory flow (PEF) and symptoms diary over a 2-mo period. Children with wheeze had significantly reduced PEF (p = 0.001) and higher sputum eosinophils when compared with the cough, chest cold, and control groups (3.1% versus 0.5%, 0%, 0%; p = 0.03). The prevalence of eosinophilic bronchitis (sputum eosinophils > 2.5%) was 45% in the wheeze group, which was significantly higher than the control group (9.35%, p = 0.04). Eosinophilic bronchitis was present in two children with cough (20%) and two with chest colds (15%, p > 0.05 versus control). In these groups, eosinophilic bronchitis was not associated with airway hyperresponsiveness (AHR) to hypertonic saline (p > 0.05). Children with cough and chest colds reported greater exposure to environmental tobacco smoke. In conclusion, this community-based survey of children with chronic respiratory symptoms has shown that wheeze is a good discriminator for the presence of eosinophilic bronchitis, and that persistent cough and recurrent chest colds without wheeze should not be considered a variant of asthma. Eosinophilic bronchitis did occur in a significant minority of these "variant asthma" syndromes.
Relation
American Journal of Respiratory and Critical Care Medicine Vol. 164, Issue 6, p. 977-981
Relation
http://ajrccm.atsjournals.org/cgi/content/abstract/164/6/977
Date
2001
Publisher
American Thoracic Society
Keyword(s)
asthma;  child;  cough;  eosinophilia;  induced sputum wheeze
Resource Type
journal article
Identifier
http://hdl.handle.net/1959.13/26978
Identifier
ISSN:1073-449X
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Subject
"American Journal of Respiratory and Critical Care Medicine"
 
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