Wheezy bronchitis in childhood – a distinct clinical entity with lifelong significance?

C. A. Edwards, Liesl Marten Osman, David John Godden, J. G. Douglas

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

Background: Historically, clinicians have recognized the existence of the clinical syndrome of childhood wheezy bronchitis. In the late 1960s, children with this syndrome were relabeled as having asthma, and the term wheezy bronchitis was abandoned. In a 1989 study of a cohort that originally had been studied in 1964, we reported that those who had childhood wheezy bronchitis had as adults attained lung function similar to that of healthy control subjects and had less significant symptoms than did those who had experienced childhood asthma, in whom lung function was reduced. in this study, we reexamined these subjects 12 years later to determine whether the improved outcome of the wheezy bronchitis group had been maintained.

Methods: In 2001, we followed up the 283 participants of the 1989 study, who were now aged 45 to 50 years. In interviews, respiratory symptoms and smoking status were assessed. Spirometry was measured.

Results: One hundred seventy-seven subjects (63%) completed the study. After adjusting for age, height, gender, socioeconomic status, smoking status, and number of pack-years smoked, the current FEV1 in the childhood asthma group (mean, 2.45 L; 95% confidence interval, 2.29 to 2.62) was significantly lower than the wheezy bronchitis group (2.78 L, 95% confidence interval, 2.64 to 2.91; p < 0.01) and the control group (2.96 L; 95% confidence interval, 2.83 to 3.1; p < 0.01). The difference between the wheezy bronchitis group and the control subjects was not significant (p = 0.06). Between 1989 and 2001, both the childhood wheezy bronchitis group (p < 0.01) and the childhood asthma group (p = 0.01) had greater declines in FEV1 than did the control group (asthma group decline, -0.75 L [95% confidence interval, -0.66 to -0.84]; wheezy bronchitis group decline, -0.75 L [95% confidence interval, -0.68 to -0.83]; control group decline, -0.59 L [95% confidence interval, -0.52 to -0.67]). In 2001, the asthma group had more symptoms than did the wheezy bronchitis group (p < 0.01), who were more symptomatic than the control group (p < 0.01).

Conclusion: Those with childhood wheezy bronchitis, having achieved normal lung function in earlier adulthood, now show a more rapid decline in lung function than did control subjects. If this rate of decline persists, these subjects may develop obstructive airways disease in later life.

Original languageEnglish
Pages (from-to)18-24
Number of pages6
JournalChest
Volume124
DOIs
Publication statusPublished - 2003

Keywords

  • asthma
  • longitudinal study
  • lung function
  • respiratory symptoms
  • wheezy bronchitis
  • ADULT LUNG-FUNCTION
  • NATURAL-HISTORY
  • RESPIRATORY SYMPTOMS
  • VENTILATORY FUNCTION
  • DEPRIVATION INDEXES
  • PULMONARY-FUNCTION
  • ASTHMA
  • DECLINE
  • SMOKING
  • INFECTION

Cite this

Wheezy bronchitis in childhood – a distinct clinical entity with lifelong significance? / Edwards, C. A.; Osman, Liesl Marten; Godden, David John; Douglas, J. G.

In: Chest, Vol. 124, 2003, p. 18-24.

Research output: Contribution to journalArticle

Edwards, C. A. ; Osman, Liesl Marten ; Godden, David John ; Douglas, J. G. / Wheezy bronchitis in childhood – a distinct clinical entity with lifelong significance?. In: Chest. 2003 ; Vol. 124. pp. 18-24.
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title = "Wheezy bronchitis in childhood – a distinct clinical entity with lifelong significance?",
abstract = "Background: Historically, clinicians have recognized the existence of the clinical syndrome of childhood wheezy bronchitis. In the late 1960s, children with this syndrome were relabeled as having asthma, and the term wheezy bronchitis was abandoned. In a 1989 study of a cohort that originally had been studied in 1964, we reported that those who had childhood wheezy bronchitis had as adults attained lung function similar to that of healthy control subjects and had less significant symptoms than did those who had experienced childhood asthma, in whom lung function was reduced. in this study, we reexamined these subjects 12 years later to determine whether the improved outcome of the wheezy bronchitis group had been maintained.Methods: In 2001, we followed up the 283 participants of the 1989 study, who were now aged 45 to 50 years. In interviews, respiratory symptoms and smoking status were assessed. Spirometry was measured.Results: One hundred seventy-seven subjects (63{\%}) completed the study. After adjusting for age, height, gender, socioeconomic status, smoking status, and number of pack-years smoked, the current FEV1 in the childhood asthma group (mean, 2.45 L; 95{\%} confidence interval, 2.29 to 2.62) was significantly lower than the wheezy bronchitis group (2.78 L, 95{\%} confidence interval, 2.64 to 2.91; p < 0.01) and the control group (2.96 L; 95{\%} confidence interval, 2.83 to 3.1; p < 0.01). The difference between the wheezy bronchitis group and the control subjects was not significant (p = 0.06). Between 1989 and 2001, both the childhood wheezy bronchitis group (p < 0.01) and the childhood asthma group (p = 0.01) had greater declines in FEV1 than did the control group (asthma group decline, -0.75 L [95{\%} confidence interval, -0.66 to -0.84]; wheezy bronchitis group decline, -0.75 L [95{\%} confidence interval, -0.68 to -0.83]; control group decline, -0.59 L [95{\%} confidence interval, -0.52 to -0.67]). In 2001, the asthma group had more symptoms than did the wheezy bronchitis group (p < 0.01), who were more symptomatic than the control group (p < 0.01).Conclusion: Those with childhood wheezy bronchitis, having achieved normal lung function in earlier adulthood, now show a more rapid decline in lung function than did control subjects. If this rate of decline persists, these subjects may develop obstructive airways disease in later life.",
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author = "Edwards, {C. A.} and Osman, {Liesl Marten} and Godden, {David John} and Douglas, {J. G.}",
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AU - Edwards, C. A.

AU - Osman, Liesl Marten

AU - Godden, David John

AU - Douglas, J. G.

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Y1 - 2003

N2 - Background: Historically, clinicians have recognized the existence of the clinical syndrome of childhood wheezy bronchitis. In the late 1960s, children with this syndrome were relabeled as having asthma, and the term wheezy bronchitis was abandoned. In a 1989 study of a cohort that originally had been studied in 1964, we reported that those who had childhood wheezy bronchitis had as adults attained lung function similar to that of healthy control subjects and had less significant symptoms than did those who had experienced childhood asthma, in whom lung function was reduced. in this study, we reexamined these subjects 12 years later to determine whether the improved outcome of the wheezy bronchitis group had been maintained.Methods: In 2001, we followed up the 283 participants of the 1989 study, who were now aged 45 to 50 years. In interviews, respiratory symptoms and smoking status were assessed. Spirometry was measured.Results: One hundred seventy-seven subjects (63%) completed the study. After adjusting for age, height, gender, socioeconomic status, smoking status, and number of pack-years smoked, the current FEV1 in the childhood asthma group (mean, 2.45 L; 95% confidence interval, 2.29 to 2.62) was significantly lower than the wheezy bronchitis group (2.78 L, 95% confidence interval, 2.64 to 2.91; p < 0.01) and the control group (2.96 L; 95% confidence interval, 2.83 to 3.1; p < 0.01). The difference between the wheezy bronchitis group and the control subjects was not significant (p = 0.06). Between 1989 and 2001, both the childhood wheezy bronchitis group (p < 0.01) and the childhood asthma group (p = 0.01) had greater declines in FEV1 than did the control group (asthma group decline, -0.75 L [95% confidence interval, -0.66 to -0.84]; wheezy bronchitis group decline, -0.75 L [95% confidence interval, -0.68 to -0.83]; control group decline, -0.59 L [95% confidence interval, -0.52 to -0.67]). In 2001, the asthma group had more symptoms than did the wheezy bronchitis group (p < 0.01), who were more symptomatic than the control group (p < 0.01).Conclusion: Those with childhood wheezy bronchitis, having achieved normal lung function in earlier adulthood, now show a more rapid decline in lung function than did control subjects. If this rate of decline persists, these subjects may develop obstructive airways disease in later life.

AB - Background: Historically, clinicians have recognized the existence of the clinical syndrome of childhood wheezy bronchitis. In the late 1960s, children with this syndrome were relabeled as having asthma, and the term wheezy bronchitis was abandoned. In a 1989 study of a cohort that originally had been studied in 1964, we reported that those who had childhood wheezy bronchitis had as adults attained lung function similar to that of healthy control subjects and had less significant symptoms than did those who had experienced childhood asthma, in whom lung function was reduced. in this study, we reexamined these subjects 12 years later to determine whether the improved outcome of the wheezy bronchitis group had been maintained.Methods: In 2001, we followed up the 283 participants of the 1989 study, who were now aged 45 to 50 years. In interviews, respiratory symptoms and smoking status were assessed. Spirometry was measured.Results: One hundred seventy-seven subjects (63%) completed the study. After adjusting for age, height, gender, socioeconomic status, smoking status, and number of pack-years smoked, the current FEV1 in the childhood asthma group (mean, 2.45 L; 95% confidence interval, 2.29 to 2.62) was significantly lower than the wheezy bronchitis group (2.78 L, 95% confidence interval, 2.64 to 2.91; p < 0.01) and the control group (2.96 L; 95% confidence interval, 2.83 to 3.1; p < 0.01). The difference between the wheezy bronchitis group and the control subjects was not significant (p = 0.06). Between 1989 and 2001, both the childhood wheezy bronchitis group (p < 0.01) and the childhood asthma group (p = 0.01) had greater declines in FEV1 than did the control group (asthma group decline, -0.75 L [95% confidence interval, -0.66 to -0.84]; wheezy bronchitis group decline, -0.75 L [95% confidence interval, -0.68 to -0.83]; control group decline, -0.59 L [95% confidence interval, -0.52 to -0.67]). In 2001, the asthma group had more symptoms than did the wheezy bronchitis group (p < 0.01), who were more symptomatic than the control group (p < 0.01).Conclusion: Those with childhood wheezy bronchitis, having achieved normal lung function in earlier adulthood, now show a more rapid decline in lung function than did control subjects. If this rate of decline persists, these subjects may develop obstructive airways disease in later life.

KW - asthma

KW - longitudinal study

KW - lung function

KW - respiratory symptoms

KW - wheezy bronchitis

KW - ADULT LUNG-FUNCTION

KW - NATURAL-HISTORY

KW - RESPIRATORY SYMPTOMS

KW - VENTILATORY FUNCTION

KW - DEPRIVATION INDEXES

KW - PULMONARY-FUNCTION

KW - ASTHMA

KW - DECLINE

KW - SMOKING

KW - INFECTION

U2 - 10.1378/chest.124.1.18

DO - 10.1378/chest.124.1.18

M3 - Article

VL - 124

SP - 18

EP - 24

JO - Chest

JF - Chest

SN - 0012-3692

ER -