Common behavioral problems among children with asthma: is there a role of asthma treatment?

BACKGROUND: An increased prevalence of behavioral problems has been described among children with asthma. OBJECTIVE: To investigate those associations between common behavioral problems and asthma, with an emphasis on the roles of medications used for asthma. METHOD: We studied 409 children who had been followed-up in pediatric allergy clinics and 157 age-matched healthy controls. A diagnostic and statistical manual disorder-referenced symptom inventory was used to assess "attention deficit-hyperactivity disorder" (ADHD), "attention deficit" (AD), "hyperactivity and impulsivity" (HI), and "oppositional defiant disorder" (ODD) behavioral problems. RESULTS: The study group consisted of 409 patients (male: 251, female: 158), with a mean age of 9.0 ± 2.67 years, and the control group consisted of 157 children (male: 75, female: 82), with a mean age of 9.0 ± 2.86 years. Prevalences of AD, hyperactivity, ADHD, and ODD were not significantly different between the study and control groups. Among those patients receiving leukotriene antagonist (LA) drugs adjunctive to inhaled corticosteroids (ICS), duration of treatment was correlated with total scores calculated for hyperactivity (P = .035, r = 0.432), AD (P = .044, r = 0.414), ADHD (P = .042, r = 0.418), and ODD (P = .032, r = 0.439). Among patients with asthma, children with ODD had a significantly longer duration of LA+ICS use (P = .024) compared with those with no ODD. Patients with hyperactivity had a longer duration of ICS+LA use compared with those with no hyperactivity (P = .009). Patients with asthma receiving LA+ICS treatment had a higher risk for oppositional behavior (4.282 times compared with the control group [P = .042, confidence interval (CI): 1.542-15.949]) and 8.3 times compared with patients with asthma not using any drug (P = .021, CI: 1.419-48.543). CONCLUSION: Rather than asthma itself, adjunctive use of ICS+LA therapy appears to be related with symptoms of common behavioral problems, including hyperactivity, AD, ADHD, and ODD and to increase the risk of ODD.

[Relationship between migraine-type headache in childhood with cow's milk allergy and egg-white allergy]. / Çocukluk çaginda migren tipi basagrisi ile inek sütü ve yumurta aki allerjisi arasindaki iliski.

OBJECTIVES: Migraine is a very common headache disorder. Due to the co-occurrence of migraine and allergic disorders, allergic mechanisms have been thought to play a role in migraine pathophysiology. This study aimed to investigate the association between cow's milk allergy and egg-white allergy and migraine-type headache of childhood. METHODS: We included 39 children with migraine-type headache and 167 children with no headache who had been evaluated previously in a school screening study program. Egg-white and cow's milk-specific IgE levels were measured for all involved subjects. RESULTS: Specific IgE levels were positive for cow's milk in 4 children and for egg-white in 2 children, respectively. No meaningful relationship was detected between food allergies and migraine. However, specific IgE levels for egg-white were significantly higher in migraineurs (p=0.008). CONCLUSION: Childhood migraine does not appear to be associated with cow's milk or egg-white allergy. However, the elevation of egg-white-specific IgE levels in migraine-type headache may signify the possible presence of shared pathogenetic pathways in the development of migraine and food allergies.