BRONCHIAL OBSTRUCTION IN PRESCHOOL CHILDREN: CURRENT ISSUES IN ASSESSMENT, DIAGNOSIS AND MANAGEMENT OF THIS CLINICAL CONDITION

Abstract

Inflammation of the bronchial wall rather than bronchoconstriction appears much more likely to cause bronchial obstruction in young children. Bronchial obstruction in preschool children usually interrelate with intermittent and persistent wheezing. Wheezing is usually induced by respiratory viruses, irritants and allergens. Preschool children are common recurrent wheezers due to frequent respiratory infections. Some of transient and persistent wheezers switch to chronic obstructive lung diseases later in their lives. Unfortunately due to limited diagnostic value of spirometry and nitric oxide levels measurement in the airways of preschool children is lost the use of these tools in the set of outpatient wheezers. The lack of diagnostic tools for bronchial obstruction in preschool children frequently result in delay of bronchial asthma diagnosis. In this paper current issues on definition, diagnosis and treatment of wheezing disorders in preschool children with reference to ERS Task Force report are presented. In conclusion the clinical case of severe childhood asthma phenotype progressing despite continuouos antiinflammatory treatment is presented.