Article Text

BRONCHIAL ASTHMA AND TOXOCAROSIS IN CHILDHOOD: A LONGITUDINAL STUDY IN HUNGARY
  1. O Bede3,
  2. K Gyurkovits2,
  3. D Nagy3
  1. 1Department of Parasitology, Johan Bela National Center for Epidemiology, Budapest, Hungary
  2. 2Hospital for Chest Diseases of The Hungarian Reformed Church, Mosdos, Hungary
  3. 3Department of Pediatrics, Albert Szent-Gyorgyi Medical University, Szeged, Hungary

Abstract

Toxocara infestation is associated with an increased prevalence of airway symptoms.

Objective and Methods One-hundred and thirty-six of 425 children (32%) aged 2–17 years were seropositive for T. canis antigens. Ninety-three children were adequately assessed, diagnosed and followed up during 1 year.

Results Bronchial asthma was diagnosed in 40%, cough variant asthma (CVA) in 27% and nonasthmatic eosinophilic bronchitis (NAEB) in 33% of children with chronic cough. The eosinophil cell count, the Toxocara canis IgG, the total IgE levels and the total Mg concentrations in the serum are predictors of the improvement or the decline of the patients’ condition. Presuming the etiopathogenetic role of T. canis in the inflammatory process of chronic cough, we treated children not only with inhaled corticosteroid (ICS), but also with anthelminthics, in the form of a 1-week course of treatment. We could significantly decrease the dose of ICS in 23 of 37 (62%) children with bronchial asthma. Anthelminthics and avoidance were sufficient for children with NAEB; none needed ICS. ICS therapy could be stopped 2–3 months later in 17 (68%) of 25 patients with CVA. We found that 8 of 25 patients with CVA (32%) presented asthmatic symptoms at the end of the 1-year period.

Conclusions In Hungary, T. canis may be the potential sensitizer for chronic cough in seropositive children. Deworming therapy will then alleviate the airway symptoms without exacerbation in patients with bronchial asthma, and definitively treat children with NAEB and the majority of children with CVA.

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