Division of Hematology/Oncology, Department of Internal Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth Houston), Houston, TX, USA.
Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth Houston) and Children's Memorial Hermann Hospital, Houston, TX, USA.
J Asthma. 2023 Sep;60(9):1787-1792. doi: 10.1080/02770903.2023.2187305. Epub 2023 Mar 21.
Asthma in preschool children is poorly defined, proving to be a challenge for early detection. The Breathmobile Case Identification Survey (BCIS) has been shown to be a feasible screening tool in older SCD children and could be effective in younger children. We attempted to validate the BCIS as an asthma screening tool in preschool children with SCD.
This is a prospective, single-center study of 50 children aged 2-5 years with SCD. BCIS was administered to all patients and a pulmonologist blinded to the results evaluated patients for asthma. Demographic, clinical, and laboratory data were obtained to assess risk factors for asthma and acute chest syndrome in this population.
Asthma prevalence ( = 3/50; 6%) was lower than atopic dermatitis (20%) and allergic rhinitis (32%). Sensitivity (100%), specificity (85%), positive predictive value (30%), and negative predictive value (100%) of the BCIS were high. Clinical demographics, atopic dermatitis, allergic rhinitis, asthma, viral respiratory infection, hematology parameters, sickle hemoglobin subtype, tobacco smoke exposure, and hydroxyurea were not different between patients with or without history of ACS, although eosinophil was significantly lower in the ACS group ( = 0.0093). All those with asthma had ACS, known viral respiratory infection resulting in hospitalization (3 RSV and 1 influenza), and HbSS (homozygous Hemoglobin SS) subtype.
The BCIS is an effective asthma screening tool in preschool children with SCD. Asthma prevalence in young children with SCD is low. Previously known ACS risk factors were not seen, possibly from the beneficial effects of early life initiation of hydroxyurea.
学龄前儿童哮喘的定义不明确，这给早期发现带来了挑战。Breathmobile 病例识别调查（BCIS）已被证明是一种可行的筛查工具，适用于年长的 SCD 儿童，并且可能对年幼的儿童有效。我们试图验证 BCIS 作为 SCD 学龄前儿童哮喘的筛查工具。
这是一项针对 50 名 2-5 岁 SCD 儿童的前瞻性单中心研究。对所有患者进行 BCIS 评估，并由一位对结果不知情的肺科医生评估患者的哮喘情况。收集人口统计学、临床和实验室数据，以评估该人群中哮喘和急性胸部综合征的危险因素。
哮喘患病率（3/50；6%）低于特应性皮炎（20%）和过敏性鼻炎（32%）。BCIS 的灵敏度（100%）、特异性（85%）、阳性预测值（30%）和阴性预测值（100%）均较高。BCIS 阳性患者与 ACS 病史患者在临床人口统计学特征、特应性皮炎、过敏性鼻炎、哮喘、病毒性呼吸道感染、血液学参数、镰状血红蛋白亚型、吸烟暴露和羟基脲使用方面无差异，尽管 ACS 组的嗜酸性粒细胞明显较低（=0.0093）。所有哮喘患者均有 ACS、已知的导致住院的病毒性呼吸道感染（3 例 RSV 和 1 例流感）和 HbSS（纯合血红蛋白 SS）亚型。
BCIS 是 SCD 学龄前儿童中一种有效的哮喘筛查工具。年幼的 SCD 儿童哮喘患病率较低。先前已知的 ACS 危险因素并未出现，这可能是由于早期使用羟基脲带来了有益的效果。
