Recognizing early asthma

Asthma symptoms often develop during the first years of life. Longitudinal studies show that at least 40% of children with wheezing lower respiratory illnesses (LRIs) during the first 3 years of life still have wheezing episo des at 6 years of age. Thus, it is important to identify children at risk o f developing asthma, and to distinguish these from those in whom early whee zing is likely to be transient. This is complicated, however, by the variab le nature of asthma and the lack of specific and sensitive markers. Genetic markers and epidemiologic risk factors for asthma have been identified, bu t cannot be used to predict the development of asthma in an individual pati ent. Similarly, infants who subsequently develop asthma in childhood have h igher serum immunoglobulin E (IgE) and peripheral eosinophil counts than th ose who do not develop asthma, but, again, these factors are not sufficient ly sensitive and specific to allow identification of children at risk of de veloping asthma. An algorithm is presented that outlines possible criteria to determine the risk of developing asthma in infants.