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Asthma Does Know Gender
While boys account for nearly two of
three children with severe asthma, more than two of three adults
with severe asthma are women.
The reasons for that gender shift
between childhood and adulthood aren't clear, says a study in
the October issue of Chest.
Researchers from National Jewish
Medical and Research Center also found children with severe asthma
had surprisingly good airflow in and out of their lungs. That
indicates that even children seriously ill with asthma could be
misdiagnosed and under-treated, the study says.
"Our findings highlight many
of the significant differences between severe asthma in children
and adults. We hope they will spur further research that can lead
to a better understanding and better treatment of this disease,"
lead researcher Dr. Joseph Spahn says in a prepared statement.
He and his team examined data on
275 people with severe asthma who had been referred to National
Jewish. Males accounted for 62 percent of the patients under age
18, while women accounted for 68 percent of those over 18 with
severe asthma.
Similar ratios have been noted
in people with mild and moderate asthma. This is the first study
to document the situation in people with severe asthma.
"There has been speculation
that a woman's hormones or possibly differences in the size of
male and female lungs play a role in this changing pattern of
asthma prevalence, but no one really knows for sure why it occurs,"
Spahn says.
"If we could learn why, we
might gain valuable insight that could help us better treat all
our asthma patients," he says.
Spahn and his colleagues also found
that children with severe asthma had deceptively good lung function.
One of the primary measures used
to diagnose and categorize asthma is forced expiratory volume
in one second (FEV1). It measures the amount of air a person can
exhale in a second. People are deemed to have severe asthma when
their FEV1 is less than 60 percent of the value for healthy people
of the same size and age.
In this study, adults with severe
asthma had an average FEV1 that was 57 percent of the healthy
average. But the children with severe asthma averaged an FEV1
of 74 percent and many exceeded 90 percent.
"The good news is that children
have significantly less impaired lung function than do adults
with asthma. The bad news is that existing guidelines do not reflect
this fact, and physicians may be mistakenly reassured by normal
or near normal lung function readings in their pediatric patients,"
Spahn says.
"As a result, they may fail
to appreciate the severity of their patients' asthma and under-treat
them," he adds.
More information
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Reference
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