Home > Journals > Minerva Pediatrica > Past Issues > Minerva Pediatrica 2017 August;69(4) > Minerva Pediatrica 2017 August;69(4):274-80

CURRENT ISSUE
 

ARTICLE TOOLS

Publication history
Reprints
Cite this article as

MINERVA PEDIATRICA

A Journal on Pediatrics, Neonatology, Adolescent Medicine,
Child and Adolescent Psychiatry


Indexed/Abstracted in: CAB, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,764


eTOC

 

ORIGINAL ARTICLE  


Minerva Pediatrica 2017 August;69(4):274-80

DOI: 10.23736/S0026-4946.16.04244-4

Copyright © 2015 EDIZIONI MINERVA MEDICA

language: English

Predictive risk factors for relapse after cessation of inhaled corticosteroids in well-controlled childhood asthma

Hacer AKTURK 1, Elif, KARAKOC-AYDINER 2 , Ahmet OZEN 2, Safa BARIS 2, Tunc AKKOC 2, Nerin Nadir BAHCECILER 3, Isil BARLAN 2

1 Department of Pediatrics, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey; 2 Department of Pediatric Allergy and Immunology, Marmara Medical Faculty, Istanbul, Turkey; 3 Department of Pediatric Allergy and Immunology, Near East University Medical School, Nicosia, Cyprus


PDF  


BACKGROUND: There is limited data for predicting the risk of exacerbations following the cessation of inhaled corticosteroids (ICS) in well controlled childhood asthma. In current study, clinical, functional and inflammatory parameters at the time of ICS withdrawal were investigated in that respect.
METHODS: Forty children asymptomatic for at least 3 months on low dose ICS’s were enrolled and ICS were discontinued in summer. At enrolment symptom/medication diary, pulmonary function parameters, methacholine provocation testing, peripheral blood eosinophilia, serum total and allergen-specific IgE levels and skin prick testing were performed. In a subgroup of patients, phytohemaglutinin induced secretion of IL-5, IL-13, IFN-γ and IL-10 from blood mononuclear cells were measured. Patients were assessed with symptom/medication diary and pulmonary function test every 2 months for 6 months.
RESULTS: Eighteen of 37 patients experienced recurrence of acute asthma symptoms. In patients with acute attack (group I), changes in rhinitis symptom scores at 2nd month vs. baseline were statistically higher. In addition, group I had significantly higher rhinitis symptom scores compared to group II at fourth-month visit. Patients with acute exacerbation revealed a significant decrease in FEV1% at 2nd month compared to baseline. Moreover, group I showed significantly lower FEF 25-75% compared to group II at 2nd month. Baseline bronchial hyper-responsiveness with methacholine was found to be an independent risk factor for asthma exacerbation.
CONCLUSIONS: The findings of this study identified baseline bronchial hyperreactivity, higher rhinitis symptom scores and gradual decrease in pulmonary function parameters during follow-up as risk factors for subsequent exacerbation of asthma.


KEY WORDS: Asthma - Bronchial hyperreactivity - Rhinitis - Cytokine

top of page

Publication History

Issue published online: June 7, 2017
Article first published online: September 10, 2015
Manuscript accepted: September 9, 2015
Manuscript revised: July 17, 2015
Manuscript received: December 25, 2014

Cite this article as

Akturk H, Karakoc-Aydiner E, Ozen A, Baris S, Akkoc T, Bahceciler NN, et al. Predictive risk factors for relapse after cessation of inhaled corticosteroids in well-controlled childhood asthma. Minerva Pediatr 2017;69:274-80. DOI: 10.23736/S0026-4946.16.04244-4

Corresponding author e-mail

elif_karakoc@hotmail.com