The outcome of asthma among Greek children

Introduction: The natural history of childhood asthma is not fully clarified. This is the first study in Greece on asthma outcome among children. Aims: To investigate asthma outcome and prognostic factors of severity among children. Methods: The study included 148 adults with childhood asthma, diagnosed and monitored at the outpatient clinic of a tertiary university hospital. All subjects completed a focused questionnaire on current asthma and atopy and asthma symptoms at the ages of 10 and 16 years. The subjects were invited for evaluation with clinical history, spirometry, exercise and metacholine challenge and skin prick tests. Results: 78 subjects (52.7%) with a mean age of 27 years agreed to participate in the reevaluation. Free of symptoms were 18/78 (23.1%). Almost half of the symptomatic adults (31/60) had intermittent symptoms. 20/29 (69%) with persistent symptoms had mild asthma. The mean age of remission was 15 years. 23 subjects (29.4%) relapsed after a period of remission. FEV1/FVC < 80% had 29/78 (37.1%), irrespective of severity level. Asthma severity in childhood was associated with FEV1/FVC in adulthood (p=0.007). The persistence of asthma up to the the age of 16 years was an unfavourable predictive factor (p=0.04). Bronchial hyperreactivity demonstrated by 27/76 (35.5%) and was associated with current severity and pulmonary function. 59/72 (82%) had positive skin prick tests. Atopy in childhood or in adulthood was not associated with current severity. Atopy in adulthood was associated with bronchial hyperreactivity (p=0.012). Conclusions: Although 60/78 (76.9%) subjects of our sample continued to have asthma on reevaluation, the majority (51/60= 85%) had rather mild symptoms.