Most preschoolers with viral wheezing exacerbations are not atopic. However, wheezing preschoolers presenting to the ED may be a unique population.
This prospective trial from Israel included 41 wheezing preschoolers presenting to the ED, 30 of them had bronchial challenge tests, 22 had induced sputum.
Significantly more wheezing preschoolers (48.7%) had a positive stringent asthma predictive index (S-API) compared with the community control group (13.7%). In addition, 85.2% had a positive adenosine- bronchial challenge test (BCT) versus 17.5% in the control group. Among wheezing preschoolers presenting to ED, 50% showed eosinophilia in the induced sputum.
Wheezing preschoolers presenting to the ED are a unique population with significantly higher rate of positive stringent asthma predictive index (S-API) and adenosine-BCT compared with controls and frequently (50%) express eosinophilic airway inflammation.
Asthma-predictive-index, bronchial-challenge, sputum eosinophils in acutely wheezing preschoolers. Dorit Ater et al. Pediatric Pulmonology, Oct 2013. DOI: 10.1002/ppul.22926