Stability and predictiveness of multiple trigger and episodic viral wheeze in preschoolers

Clin Exp Allergy. 2016 Jun;46(6):837-47. doi: 10.1111/cea.12660.

Abstract

Background: In 2008, the European Respiratory Society Task Force proposed the terms multiple-trigger wheeze (MTW) and episodic (viral) wheeze (EVW) for children with wheezing episodes. We determined MTW and EVW prevalence, their 24-month stability and predictiveness for asthma.

Methods: In total, 565 preschoolers (1-, 2- and 3-year-olds) in primary care with respiratory symptoms were followed until the age of 6 years when asthma was diagnosed. MTW status and EVW status were determined using questionnaire data collected at baseline and after one and 2 years. We distinguished 3 phenotypes and determined their 24-month stability, also accounting for treatment with inhaled corticosteroids (ICS). Logistic regression was used to analyse the phenotypes' associations with asthma.

Results: Two hundred and eighty-one children had complete information. MTW and EVW were stable in 10 of 281 (3.6%) and 24 of 281 (8.5%), respectively. The odds of developing asthma for children with stable MTW and stable EVW were 14.4 (1.7-119) and 3.6 (1.2-11.3) times greater than those for children free of wheeze (for at least 1 year). ICS was associated with increased stability of MTW and EVW.

Conclusions: Stable multiple-trigger and stable episodic viral wheeze are relatively uncommon. However, 1- to 3-year-olds with stable MTW are at much increased risk of asthma.

Keywords: asthma; cohort studies; episodic viral wheeze; multiple-trigger wheeze; preschool children; primary health care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Immunoglobulin E / blood
  • Immunoglobulin E / immunology
  • Infant
  • Male
  • Phenotype
  • Population Surveillance*
  • Prevalence
  • Prognosis
  • Respiratory Sounds / etiology*
  • Risk Factors
  • Virus Diseases / complications*

Substances

  • Adrenal Cortex Hormones
  • Immunoglobulin E