Difficult asthma: beyond the guidelines

Balfour‐Lynn, Ian M.

doi:10.1136/adc.80.2.201

Cited by 34 publications

(14 citation statements)

References 40 publications

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“…Immunodeficiencies should also be excluded; an initial screen should include serum immunoglobulins and IgG subclasses, complement concentrations, and antibody responses to common antigens (diphtheria, tetanus, Haemophilus influenzae type B, and pneumococcus) (21). Treatment depends on the underlying deficiency but may involve antibiotics for exacerbations, regular prophylactic antibiotics, or, in severe cases, regular infusions of replacement immunoglobulin.…”

Section: Immune Deficiencymentioning

confidence: 99%

Children with Difficult Asthma: A Practical Approach

Payne¹,

Balfour‐Lynn²

2001

Journal of Asthma

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Many open studies investigating the effects of innovative treatments for steroid-dependent asthma demonstrate some benefit. This is also true of the majority of placebo arms in placebo-controlled trials. This suggests that children with difficult asthma benefit from the high level of input that is typically provided in clinical trials, with or without additional medication. Such intensive management of patients, with the emphasis on establishing the diagnosis, improving adherence, and identifying provoking factors, is the key to optimizing asthma control for these children. For patients with genuinely severe asthma, despite high doses of conventional treatment, a greater understanding of the pathological basis of persistent symptoms is needed. Identification of different pathological subtypes of severe asthma should allow for more rational prescribing of asthma therapy, as well as the design of further trials of potential steroid-sparing treatments.

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Section: Immune Deficiencymentioning

confidence: 99%

Children with Difficult Asthma: A Practical Approach

Payne¹,

Balfour‐Lynn²

2001

Journal of Asthma

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“…BAL and BB were justified to exclude alternative diagnosis and assess airway inflammation to optimize asthma treatment. 9,10 Children were evaluated after at least 15 days without acute exacerbations to ensure that the explorations reflected their basal status.…”

Section: Patientsmentioning

confidence: 99%

Both inflammation and remodeling influence nitric oxide output in children with refractory asthma

Mahut¹,

Delclaux²,

Tillie‐Leblond³

et al. 2004

Journal of Allergy and Clinical Immunology

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“…1 This group of children has not previously been well described. The European Respiratory Society's Working Party on Dif®cult/Therapy-Resistant Asthma recommended an integrated approach to the problem, 2 and the National Health Service Executive Research and Development Programme identi®ed severe asthma as a priority for project funding in 1995.…”

Section: Introductionmentioning

confidence: 97%