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  • With Mayo Clinic asthma and allergy specialist

    James T. Li, M.D.

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Mayo Clinic Health Manager

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Question

Will my child outgrow asthma?

I've heard that children can outgrow asthma. Is this true?

Answer

from James T. Li, M.D.

Yes and no. Asthma symptoms get better in some children during adolescence and young adulthood, and may not return. For others, symptoms go away only to return a few years later. Some children with asthma never outgrow it.

In some children, what initially appears to be asthma turns out to be something else. Typical asthma signs and symptoms such as coughing, wheezing or shortness of breath may be a sign of another condition. For example, some children under age 3 have periodic episodes of wheezing caused by a respiratory virus. As with asthma, the airways become inflamed and tighten up. But unlike asthma, the underlying cause doesn't involve an allergic response, and symptoms typically improve as the child gets older. On the other hand, conditions diagnosed as other conditions, such as wheezy bronchitis, recurrent pneumonia and reactive airway disease, sometimes turn out to be asthma after all.

Diagnosing asthma and ruling out other conditions in children can be difficult because asthma symptoms and triggers differ from child to child. Diagnosing asthma in children under 5 is especially challenging because young children are more likely to have other conditions that cause asthma-like symptoms. Further, lung function tests, a standard tool for diagnosing asthma in older children and adults, can't be used until a child is old enough to follow detailed instructions. Having a family history of asthma or allergies can increase the chances that your child's symptoms are likely due to asthma.

There are a few clues that your child's symptoms may be due to asthma and are likely to persist later in life. These include persistent wheezing during early childhood or a skin allergy such as atopic dermatitis or hay fever. Your child is less likely to have symptoms later in life if he or she has infrequent bouts of wheezing.

An unclear diagnosis can pose a challenge in deciding whether a child should be treated for asthma. On one hand, a child who doesn't have asthma won't benefit from asthma treatment such as inhaled corticosteroids. However, if your child does have asthma, it's important to start treatment as soon as possible. Early treatment with medications such as inhaled corticosteroids can reduce symptoms.

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References
  1. Horner CC, et al. Age-related changes in the asthmatic phenotype in children. Current Opinion in Pediatrics. 2007;19:295.
  2. Panettieri RA. Natural history of asthma: Persistence versus progression - Does the beginning predict the end? Journal of Allergy and Clinical Immunology. 2008;121:607.
  3. Guiang SF. Pediatric asthma. In: Mahmoudi M. Asthma and Allergy: Practical Diagnosis and Management. New York, NY.: McGraw Hill;2008:115
  4. National Asthma Education and Prevention Program. Expert Panel Report 3 (EPR-3): Guidelines for the diagnosis and management of asthma-Summary report 2007. http://www.nhlbi.nih.gov/guidelines/asthma/asthsumm.htm. Accessed Feb 17, 2009.

AN01973

Feb. 21, 2009

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