1A / 245 – ALLERGOLOGICAL AND LUNG FUNCTION EVALUATION IN WHEEZING INFANTS:
WHAT USEFULNESS?
A. Scaparrotta, M. Verini, N. P. Consilvio, D. Rapino, A. Cingolani, C. Spagnuolo, A. Palazzo, S. Di
Pillo, F. Chiarelli.
University of Chieti, Allergological and Respiratory Unit, Pediatric Clinic - Chieti, Italy.
Early wheezing in childhood is often transient, intermittent and associated with viral infections, so
diagnosis of asthma is not always easy in the first 3 years of life.
The aim of the study was to examine the usefulness of allergological and lung function evaluation, and
the correlations between lung function, clinical and allergological data in recurrent wheezing infants.
110 wheezing infants (mean age of 25,2 ± 12,7 months) and in 9 healthy controls (mean age 22,3 ±
7,7 months) were evaluated for atopy and allergic sensitization by total IgE, skin prick test and serum
specific IgE antibody. Lung function and bronchial hyperresponsiveness were assessed by Tidal
Breathing Flow Volume Loops (TBFVL) analysis, before and after administration of 200 μcg of inhaled
MDI Fenoterol (Bronchodilation Test= BD Test).
High total IgE levels were founded in 52% of patients (57/110). Hyperresponsiveness ( BD Test +)
were more evident in high total IgE group (BD Test + in 44/57 infants = 77%) than in low total IgE one
(BD Test + response in 28/53 infants = 52%) (Yates' chi-square test: 6.17).
Allergic sensitization was founded in 43% of patients (47/110), 100% (7/7) infants with respiratory
sensitization had a BD + response vs 60% (38/63) of not allergic ones (chi-square test: 4.32) and vs
50% (9/18) of food allergy ones (chi-square test: 5.47). Infants with food and respiratory sensitization
had BD + response in 81% (18/22) vs food allergy ones (chi-square test: 4.67).
High serum Eosinophilic Cationic Protein (sECP > 15 mcg/l) levels were founded in 90/110 (82%)
infants. Bronchial hyperresponsiveness was observed in 62/90 (69%) infants with high sECP vs 4/10
(40%) in subjects with normal ECP levels.
Our data show that respiratory sensitization, high total IgE levels and serum Eosinophilic Cationic
Protein levels can be correlated with a bronchial hyperresponsiveness assessed, already in the first
infancy, by the evaluation of bronchodilator response of Tidal Breathing Flow Volume Loops.
Our study show that is very important to perform allergological examination even in infants and young
children, who have had more then a wheezing episode. Finding respiratory sensitization and high total
IgE levels can be an indication to perform lung function evaluation by Tidal Breathing Flow Volume
Loops analysis before and after a bronchodilation test, which can identify a bronchial
hyperresponsiveness, potentially risk factors for subsequent asthma.