Abstract

Introduction

‘Wheezy child’ is a complex condition encompassing a group of diseases with distinct pathophysiology. Since wheezing attacks in early life may indicate future asthma, measuring and monitoring lung functions in preschool children and evaluating factors affecting them is important. We aimed to compare lung functions of wheezy children according to their phenotypes with healthy children and demonstrate the effect at an early age.

Materials and Methods

In this prospective study, wheezy children (n: 84) who presented to our pediatric allergy outpatient clinic between August 2023 and February 2024 and healthy children (n: 81) of similar age and gender were consecutively included. Wheezy children were classified according to phenotype as episodic (90.2%) and multiple-trigger (9.8%), and also as non-atopic (38.1%) and IgE-mediated (61.9%). Wheezy children were examined in two groups as high-risk (75%) and non-high-risk (25%). In the impulse oscillometry method, zR5, zR20, R5-20 are parameters showing airway resistance; zX5, zX20, Fres, AX are parameters showing elasticity. Lung functions were compared between the healthy group and wheezing phenotypes.

Results

Symptoms showed seasonal variation in 78% of patients, with symptoms most common in winter. 61.9% (n: 52) of patients were atopic and 54.8% (n: 46) were in the high-risk group. 38.1% (n: 32) of patients had maternal atopy, 21.4% (n: 18) had paternal atopy; 19% (n: 16) had maternal asthma, 14.3% (n: 12) had paternal asthma, 13.1% (n: 11) had maternal allergic rhinitis, and 6% (n: 5) had paternal allergic rhinitis. In the patient group, zR5, R5-20 and AX values were higher and zX5 value was lower compared to the healthy group (p<0.05). In high-risk patients, zR5 and R5-20 were found to be high (p<0.05). In those with maternal atopy, zR5, R5-20 and AX values were high (p<0.05). In multiple-trigger wheeze, zR5-20 was higher compared to the episodic group (p: 0.043). In IgE-mediated wheezy children, zR5-20 was higher compared to non-atopic wheezy children (p<0.001).

Conclusion

Inhigh-risk wheezy children and those with maternal atopy,total and peripheral airway resistances were higher.Peripheral airway resistances were found tobe high inmultiple-trigger and IgE-mediated wheeze.This study demonstrated that lung functions are impaired at an early age in different phenotype groups of wheezy children.