SELECTED ARTICLES FROM THE RECENT LITERATURE 2005

9/9/05

Asthma in remission at age 18 years - subsequent relapse

Summary
Background - Childhood asthma frequently appears to remit in adolescence. How often is such remitted asthma at age 18 years followed by relapse of asthma in early adulthood? Are there factors present at age 18 years in which predict such later recurrence of asthma?

Findings - Taylor et al of the Dunedin School of Medicine in New Zealand described on-going studies in their longitudinal study of an entire birth cohort (n=1,037) born in New Zealand in 1972-73. They found that of those with previous childhood asthma which was subsequently in remission at age 18 years, 35% had relapsed by ages 21 or 26 years. Such relapses were generally mild.

In multiple regression analysis, the presence of atopy and lower FEV-1/FVC ratios at age 18 years were independent predictors of subsequent asthma relapse. Increased bronchial hyper-responsiveness at age 15 years was more common in those whose asthma subsequently relapsed after age 18 years but the positive predictive value was low. Totally new adult onset asthma developed by age 26 years in 9% of study members who had never had asthma at any time up to age 18 years.

Reference
 Chest 2005;127:845-50

Editor's Comments
These findings are part of a long-term study that has yielded important information that counters some impressions based on more anecdotal experience. Although remission of childhood asthma by age 13 years is common, it is not unusual to see recurrence of asthma in the late teens/early 20's age period in such individuals. In my clinical practice which involved many university students with asthma, a common past history was of childhood asthma followed by remission in adolescence only to be followed by asthma recurrence at around age 20 years.

 

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