Two main wheezing phenotypes in preschool age: similarities, differences and comparisons of clinical progressions

Objective: Recurrent wheezing episodes are seen frequently and in the first three years, one out of three children has a wheezing episode. In this study, we aim to designate wheezing phenotypes, differences in their demographic features and clinical progressions. Materials and Methods: The medical charts of 385 patients who were diagnosed as wheezy child in Pediatric Allergy Department of Gazi University Faculty of Medicine, were reviewed retrospectively. The present complaints of these patients, anti-inflammatory treatments given to them and knowledge about their wheezing phenotypes were learned. Results: Two hundred ninety four (76.4%) of the wheezy children were diagnosed as episodic wheezing, 91 (23.6%) of them were classified as multitrigger wheezing. The follow-up period was 20.28 +/- 3.79 on average. When the demographic features and clinical progressions of the two phenotypes were compared, the multi-trigger wheezing group were older than the episodic wheezing group on admission (p< 0.001). In the group of multi-trigger wheezing, peripheral eosinophilia (p= 0.04), frequency of wheezing attacks in past year (p= 0.003), wheezing attacks requiring systemic steroids (p= 0.02), to be begun on anti-inflammatory treatment at the time of diagnosis (p< 0.001), the preference of inhaled steroids more than LTRAs (p< 0.001), the continuation of symptoms at the end of follow up period (p= 0.01) and the use of anti-inflammatory treatment (p< 0.001) were more common than in the episodic wheezing group. Furthermore, transition between phenotypes were more frequent in the multi-trigger group (p= 0.001). Conclusion: This study shows that the attacks in multi-trigger wheezing group are more frequent and severe and is accompanied by peripheral eosinophilia more commonly than the episodic wheezing group. The transition between phenotypes are frequent in multi-trigger wheezers in follow up.