Asthme sévère : particularités pédiatriques

Abstract: Severe asthma in children is defined by the persistence or exacerbation of asthmatic symptoms or persistence of bronchial obstruction in spite of treatment that is considered to be optimal. Management requires, first of all, that cases of false asthma, asthma lacking appropriate treatment, poor compliance and/or preventive education, asthma made worse by the persistence of an unrecognized factor and/or asthma that has not been treated must be recognized. Severe asthma calls for evaluation in specialized centers where the importance of bronchial inflammation and airway remodeling can be appreciated. That evaluation is based on data obtained by broncho-alveolar lavage and endobronchial biopsy; non-invasive methods such as measurement of exhaled NO and thoracic tomodensitometry are still being evaluated. [Copyright &y& Elsevier]