Avaliação clínica e perfil de sensibilização alergênica de crianças asmáticas acompanhadas em um programa de asma

Abstract

Asthma is a disease with high morbidity and mortality and is the major chronic respiratory disease of children and adolescents. In Brazil there is a prevalence of asthma from 16.1 to 27.2% and it represents the third cause of hospitalization by the Sistema Único de Saúde SUS (Unified Health System). It is not only a complex disease but also difficult to diagnose especially in children, because it is observed characteristic patterns of wheezing at this age. This study has aimed to describe the clinical features and verify the allergen sensitization profile of the skin prick test (SPT) in patients with asthma who were followed in Programa de Controle de Asma de Catalão-GO - Pro-asma - (Asthma Control Program of Catalão-GO) due to the high prevalence and the need for studies in the pediatric population in Brazil. The purpose is to have a better understanding of the disease and especially the way it behaves regarding the patterns of wheezing and atopy which have been observed in recent decades in childhood asthma. A clinical questionnaire has been prepared and applied to the SPT for the major aeroallergens. In a total of 301 study participants, 57% were male and had a median age of 74 months. In 80% of cases, at least one first-degree relative was atopic, 88% had clinical symptoms of rhinitis and passive smoking was found in 29% of the patients homes. The most prevalent aeroallergen was the mite and the sensitization to at least one aeroallergen was of 63%. In the analysis of the sensitization by age group, there was predominance of sensitization asthma in patients over 5 years old and non-sensitization asthma between 2 and 5 years old, with p<0,0001. It was also observed that as time passed, it took older patients more time to get the diagnosis and to initiate the treatment, also with p <0,0001. Therefore, the Pro-asma (Pro-asthma) patients were divided into two large groups: with sensitization and without sensitization. It was shown that the higher prevalence of non-atopic asthma at the age of 5 below coincides with large cohort studies of asthma in childhood. It may show that at this age group, recurrent wheezing can be transient, with no loss of lung function and without features of atopy. It is suggested that asthma may have different patterns according to age, changing the prognosis and severity of the disease.