Progression of asthma in childhood

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Presentation transcript:

Progression of asthma in childhood Ronina A. Covar, MD, Carlyne Cool, MD, Stanley J. Szefler, MD Journal of Allergy and Clinical Immunology Volume 115, Issue 4, Pages 700-707 (April 2005) DOI: 10.1016/j.jaci.2005.01.034 Copyright © 2005 American Academy of Allergy, Asthma and Immunology Terms and Conditions

Fig 1 This patient's lung function has diminished over time. Using a regression analysis based on these serial measurements of her prebronchodilator FEV1 percent predicted (in red circles) and postbronchodilator FEV1 (in green triangles) over the past 6 years, her slopes of decline were −1.1 and −2.1%/y (R2=0.15 and 0.26; P values=.09 and .0002), respectively. Journal of Allergy and Clinical Immunology 2005 115, 700-707DOI: (10.1016/j.jaci.2005.01.034) Copyright © 2005 American Academy of Allergy, Asthma and Immunology Terms and Conditions

Fig 2 Endobronchial biopsy. A, Hematoxylin and eosin–stained section shows the thickened basement membrane and a mild to moderate submucosal inflammation with scattered eosinophils. B, Stained mast cells. C, CD3 T lymphocytes. D, CD20 B lymphocytes. E, Pentachrome-stained slide (×400) demonstrates a greatly thickened basement membrane (collagen stains yellow). F and G, Deposition of elastin fibrils (black) and massive smooth muscle hypertrophy (salmon color), and goblet cell hyperplasia (turquoise). H, Goblet cells with mucus. Journal of Allergy and Clinical Immunology 2005 115, 700-707DOI: (10.1016/j.jaci.2005.01.034) Copyright © 2005 American Academy of Allergy, Asthma and Immunology Terms and Conditions

Fig 3 This patient's serial measures of FEV1 (L) with age are plotted against the predicted values determined from the National Health and Nutrition Examination Survey III normal children of the same age and sex.16 Journal of Allergy and Clinical Immunology 2005 115, 700-707DOI: (10.1016/j.jaci.2005.01.034) Copyright © 2005 American Academy of Allergy, Asthma and Immunology Terms and Conditions