[Dissociation of asthmatic syndromes in children]. / Dissociation des syndromes asthmatiques de l'enfant.

ABSTRACT

Allergic sensitization is not always the only factor in bronchial asthma in the young child, so that conventional management is often poorly effective. The main event is airflow obstruction, caused by widespread airway narrowing due to bronchospasm, mucus secretion, hypersecretion and inflammatory mucosal edema. Airway inflammation seems to be the most important factor associated with release of chemical mediators and the cellular phase of inflammation. Origin of this activation may involve exposure to environmental stimuli such as allergens, infection or pollutants. Bronchial hyperreactivity probably develops at the same time although genetic factors are likely to predispose the children to develop hyperresponsiveness. Different processes can result in bronchial obstruction and explain the forms of asthma in young children allergic, infectious or complex asthma. Since the bronchial inflammatory reaction appears to be the most important factor in the subsequent development of asthma in young children, steroid inhalation is advocated, associated with conventional therapy.