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Findings before the diagnosis of asthma in young adults

1994; Elsevier BV; Volume: 94; Issue: 5 Linguagem: Inglês

10.1016/0091-6749(94)90150-3

1097-6825

R K Dodge, M CLINE, Michael Lebowitz, B BURROWS,

Allergic Rhinitis and Sensitization

Background: Asthma is a poorly understood disease.Risk factors are not established, and the natural history of the disease is unknown.Objective: Using subjects of a community-based study, we have prospectively compared young adults destined to develop asthma with control subjects to determine differences between them before diagnosis.Methods: Subjects were participants of the Tucson Epidemiologic Study of Airways Obstructive Disease.They were studied between the ages of 15 and 19 and subsequently every 1 to 2 years until they were at least 21 years old with questionnaires, spirometT, allergy skin testing, and serum IgE testing.Results: Logistic regression showed that "wheeze" and "artacks of shortness of breath with wheeze" were independently predictive of asthma.Positive allergy skin test results occurred more ,frequently among subjects who later received a diagnosis o,f asthma, and initially these subjects had higher serum IgE levels than control subjects (geometric mean IgE = 173.8HI/ml vs 52.5 IUJml for control subjects; p < 0.005).Although initial spr'rometn'c testing did not distinguish between &ture asthmatic subjects and control subjects, repeat testing after diagnosis did show s&$cant differences in flows at low lung volumes.Conclusions: These data suggest that symptoms and findings suggestive of asthma may be Dresent for manyyears before diagnosis.(JALLERGYCLINIMMUNOL 1994;94:831-5.)Key wora's: Asthma, adults, alley, incidence, serum IgEIn the last 30 years, large-scale community studies have provided basic information about the epidemiology of asthma.le4In these reports the prevalence and incidence of the disease, as well as the course after diagnosis, are well-described, particularly in children.Also, in attempts to determine who in the general population is predisposed to the development of asthma, investigators have compared asthmatic individuals with control subjects.These comparisons have shown that asthmatic children are more likely to be atopic and to have a history of respiratory infections