Successful Management of a Boy with Mild Persistent Asthma (A Longitudinal Case)

Authors: Lubis A., Setiawati L., Setyoningrum A. R., Suryawan A., Irwanto

Abstract:

Asthma is a condition that causing chronic health problems in children. In addition to basic therapy against disease, we must try to reduce the impact of chronic health problems and also optimize their medical aspect of growth and development. A boy with mild asthma attack frequent episode did not showed any improvement with medical treatment and his asthma control test was 11. From radiologic examination he got hyperaerated lung and billateral sinusitis maxillaris; skin test results were house dust, food and pet allergy; an overweight body; bad school grades; psychological and environmental problem. We followed and evaluated this boy in 6 months, treated holistically. Even we could not do much on environmental but no more psychological and school problems, his on a good bodyweight and his asthma control test was 22. A case of a child with mild asthma attack frequent episode was reported. Asthma clinical course show no significant improvement when other predisposing factor is not well-controlled and a child’s growth and development may be affected. Improving condition of the patient can be created with the help of loving and caring way of nurturing from the parents and supportive peer group. Therefore, continuous and consistent monitoring is required because prognosis of asthma is generally good when regularly and properly controlled.

Keywords: Asthma, chronic health problems, growth and development.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1093530

References:

[1] Rahajoe N. Epidemiologi asma. In Rahajoe N, Supriyanto B, Setyanto D.B eds. Pedoman Nasional Asma Anak, 1st Edition. Jakarta: UKK Pulmonologi PP IDAI, 2004, pp. 1-3.
[2] WHO European Centre for Environment and Health. Prevalence of asthma and allergies in children. Copenhagen. WHO Regional Office for Europe, 2007.
[3] Kumar G. S., Roy G., Subitha L., Sahu K. S., Prevalence of bronchial asthma and its associated factors among school children in urban Puducherry, India. J Nat Sc Biol Med., 2014, 5, pp. 59-62.
[4] Soetjiningsih. Tumbuh kembang anak dengan kondisi kesehatan kronik. In Narendra M.B., Sularyo T.S., Soetjiningsih, Suyitno H., Ranuh I.G.N., Wiradisuria S. eds. Tumbuh kembang anak dan remaja II, 1st Edition. Jakarta: Sagung Seto, 2005, pp. 61-70.
[5] Gandhi K. P., et al. Exploring factors influencing asthma control and asthma specific health related quality of life among children. Respiratory Research., 2013, vol.14(26), pp.1-10.
[6] Kamenov S.S.P., Djordjevic D.V., Radic S.,Kamenov B.A. Asthma quality of life as a marker of disease severity and treatment evaluation in school children. Medicine and Biology., 2002, vol.9(2), pp.175-180.
[7] Liu A.H., Spahn J.D., Leung D.Y.M. Chlidhood asthma. In Behrman R.E., Klieman R.M., Jenson H.B. eds. Nelson Textbook of Pediatrics, 17th Edition. Philadelphia: Saunders, 2004, pp. 760-774.
[8] Stout W., et al. Classification of asthma severity in children. ARCH PEDIATR ADOLESC MED., 2006, vol.160, pp. 844-850.
[9] Alvarez O.O., Mikrogianakis O. Managing the paediatric patient with an acute asthma exacerbation. Paediatr Child Health., 2012, vol.17(5), pp.251-255.
[10] Holt S., Perrin K. Using the asthma control test to improve asthma outcomes. N Z Med J., 2010, vol. 123, pp. 1323.
[11] Yunginger J.W. Bronchial asthma. In Behrman R.E, Kliegman R.M, Jenson H.B. eds. Nelson Essentials of Pediatrics, 2nd Edition. Philadelphia;Saunders, 1994, pp. 263-267.
[12] Soetjipto D, Mangunkusumo E. Sinus paranasal. In Soepardi E.A, Iskandar N. eds. Buku Ajar Ilmu Kesehatan Telinga Hidung Tenggorok Kepala Leher, 5th Edition. Jakarta: Gaya Baru, 2002, pp. 122-124.
[13] Friedman R.L. Chronic sinusitis in children: a generl overview. S Afr Fam Pract ., 2011, vol.53(3), pp. 230-239.
[14] Ramadan H. H. Chronic sinusitis in children. International Journal of Pediatrics., 2012, pp.1-5.
[15] Radojicic C. Sinusitis: allergies, antibiotics, aspirin, asthma. Cleveland Clinic Journal Of Medicine., 2006, vol.73(7), pp. 671-678.
[16] Tsao C.H, Chen L.C, Yeh K.W, Huang J.L. Concomitant chronic sinusitis treatment in children with mild asthma: the effect on bronchial hyperresponsiveness. Chest., 2003, vol.123, pp. 757-764.
[17] Santosa H. Asma bronchial. In Akib Arwin A.P., Munasir Z., Kurniati N. eds. Buku Ajar Alergi-Imunologi Anak, 3rd Edition. Jakarta: Ikatan Dokter Anak Indonesia (IDAI), 2010, pp. 253-66.
[18] Zeldin Y., Weiler Z., Magen E., Tiosano L., Kidon I.M. Safety and efficacy of allergen immunotherapy in the treatment of allergic rhinitis and asthma in real life. IMAJ., 2008, vol.10, pp.869–872.
[19] Harsono A, Endaryanto A, Alergi makanan. Pedoman Diagnosis Dan Terapi. Surabaya: Rumah Sakit Umum Dokter Sutomo,2006: 8-12.
[20] Gilliland F.D., et al. Obesity and the risk of newly diagnosed asthma in school-age children. Am J epidemiol., 2003, vo.158, pp. 406-415.
[21] Tavasoli S., Heidharnazhad H., Kazemnejad A., Miri S. Association between asthma severity and obesity in two asthma clinics in Tehran. Iran J Allergy Asthma Imunol., 2005, vol. 4(4), pp. 179-184.
[22] Rance K., O’Laughlen M. Obesity and asthma: a dangerous link in children. JNP., 2011, vol. 7(4), pp.287-291.
[23] Gupta P.R. Asthma in the obese: yet another reason to lose weight. Curr Opin pharmacol., 2006, vol.6, pp. 230-236.
[24] Dixon E. A., et al. An official american thoracic society workshop report: obesity and asthma. Proc Am Thorac Soc., 2010, vol. 7, pp. 325-335.
[25] Sin D. D., Sutherland E. R. Obesity and the lung: obesity and asthma. Thorax., 2008, vol. 63, pp. 1018-1023.
[26] Musaad A. M. S., Paige N. K., Garcia T. M., Donovan M. S., Fiese H. B. Childhood overweight/obesity and pediatric asthma: the role of parental perception of child weight status. Nutriens., 2013, vol. 5, 3713-3729.
[27] Kusnandi R. Pengaruh stress dan usaha pencegahannya pada anak. In Widjaja I, Mulyanto S. eds. Pendidikan Kedokteran Berkelanjutan Tumbuh kembang, Nutrisi dan Endokrin. Kalimantan Selatan: Ikatan Dokter Anak Indonesia (IDAI) Cabang Kalsel, 2006, pp. 65-72.
[28] Lynn B. L. Growth and childhood asthma. Arch Dis Child., 1986, vol.61, pp. 1049-1055.
[29] Doul M. J. I. The effect of asthma and its treatment on growth. Arch Dis Child., 2004, vol.89, pp. 60-63.
[30] Tanner J.M. Puberty. In Tanner J.M. eds. Foetus into man: physical growth from conception to maturity, 2nd Edition. London: Castemead Publications, 1989, pp.58-74.
[31] Soetjiningsih. Tumbuh-kembang anak. In Ranuh I.G.N. eds. Tumbuh kembang anak. Jakarta:Penerbit Buku Kedokteran EGC, 1995, pp. 25-29.
[32] Brand P.L.P. Inhaled corticosteroids reduce growth. Or do they? Eur Respir J., 2001, vol.17, pp. 287-294.
[33] Schrack P.J, Bergman D.A. The effect of inhaled steroids on the linear growth of children with asthma: a meta-analysis. Pediatrics., 2000, vol. 106(1), pp.1-7.
[34] Kelly W. H., et al. Effect of inhaled glucocorticoids in childhood on adult height. N Engl J Med., 2012, vol. 367(10), pp. 904–912.
[35] Xia Y., et al. Safety of long-acting beta agonists and inhaled corticosteroids in children and adolescents with asthma. Ther Adv Drug Saf., 2013, pp.1–10.
[36] Volovitz B.Inhaled corticosteroids as rescue meditation in asthma exacerbations in children. Expert Rev Clin Immunol., 2008, vol. 4(6), pp. 695-702.
[37] Turkel S., Pao M. Late consequences of pediatric chronic illness. Psychiatr Clin North Am., 2007, vol. 30(4), pp. 819-835.
[38] Bosley C.M., Fosbury J.A., Cochrane G.M. The physiological factors associated with poor compliance with treatment in asthma. Eur Respir J., 1995, vol.8, pp. 899-904.
[39] Bloomberg R. G., Chen E. The relationship of psychologic stress with childhood asthma. Immunol Allergy Clin N Am., 2005, vol. 25, pp. 83-105.
[40] Chen E., Miller E. G, Stress and inflamation in exacerbations of asthma. Brain Behav Immun., 2007, vol. 21(8), pp. 993-999.
[41] Kamenov S.S.P., Djordjevic D.V., Radic S.S., Kamenov B.A. Asthma quality of life as a marker of disease severity and treatment evaluation in school children. Medicine and Biology., 2002, vol.9(2), pp. 175-80.
[42] Kaugar S. A., Klinnert D. M., Bender G. B. Family influences on pediatric asthma. Journal of Pediatric Psychology., 2004, 29(7), pp. 475-491.
[43] Roche N., Godard P. Control and severity: complementary approaches to asthma management. Allergy., 2007, vol.62, pp.116-119.
[44] Humbert M., Holgate S., Boulet L.P., Bousquet. Asthma control or severity: that is the question. Allergy., 2007, vol.62, pp. 95-101.
[45] Bayona M., Montealegre F., De Andrade G. L. V., Trevino F. Prognostic factors of severe asthma in Puerto Rico. PRHSJ., 2002, vol.21(3), pp.213-218.
[46] Roorda R.J. Prognostic factors for the outcome of childhood asthma in adolescence. Thorax., 1996, vol.51(1), pp. 7-12.
[47] Marco R., et al. prognostic factors of asthma severity: a 9-year international prospective cohort study. J Allergy Clin Immunol., 2006, vol.117, p.1249-1256.
[48] Uddenfeldt M. A longitudinal study of asthma, risk factors and prognosis. 2010. http://www.diva-portal.org/smash/get/diva2:360508/ FULLTEXT02.pdf. Downloaded 30 May 2014.