4 Types of Bronchial Obstruction
There are 4 types of bronchial obstruction, according to the international conciliation document PRACTALL (international recommendations for asthma in children).
1. Transient (rare, single) wheezing attacks. They may be observed in children during the first 2-3 years of life, but do not repeat after the age of 3. This means that the seizures are not related to the disease and are not a sign of asthma.
- A patient has no allergy or infection.
2. Non-atopic bronchial obstruction. It occurs, as a rule, against the background of a viral infection and tends to decrease at an older age.
- These are seizures that occur against the background of ARVI;
- In this case, the child has no signs of allergy;
- By school age, they disappear.
3. Persistent (regularly manifested) bronchial asthma. Obstruction is combined with the following factors:
- Clinical manifestations of atopy (atopic eczema, allergic rhinitis, conjunctivitis, food allergy);
- Eosinophilia and / or elevated levels of total immunoglobulin E in the blood;
- Specific IgE-mediated sensitization to food allergens in the infancy and early childhood, specific IgE-mediated sensitization to inhaled allergens at an older age;
- Sensitization to inhalant allergens at the age of up to 3 years, especially with sensitization and a high level of exposure of household allergens at home;
- Presence of bronchial asthma in parents.
4. Severe intermittent obstruction is a rare acute attack.
- Minimal manifestations in the periods between respiratory diseases;
- Signs of atopy (eczema, allergic sensitization, eosinophilia of peripheral blood).
The frequency of wheezing attack recurrence is most high in children during the first year of life. According to a long-term population-based prospective study, at least one episode of obstruction occurs at this age in 50% of all children.
This is a “risk group” for the development of bronchial asthma.
In children with such recurrent rare severe episodes of obstruction, the risk of developing persistent bronchial asthma in adolescence is increased.