| In Some, Throat Clearing
First Sign of Asthma
New findings suggest that
the first sign of asthma in a child may be simple throat-clearing.
University of Crete researchers
looked at a group of children who, according to their parents,
often cleared their throats.
About 58 percent of those children
had not been diagnosed with asthma. Half of the undiagnosed children
underwent tests of lung function, and the results showed that
those youngsters did, in fact, have the condition.
"They all had a very mild form
of asthma," Dr. Eva C. Mantzouranis told Reuters Health.
She suggested that parents of a
child who constantly clears his throat for no obvious reason should
consider getting the child tested for asthma, even if he has no
other symptoms of the condition.
However, the typical questions
doctors ask parents to determine whether children have asthma
do not include throat clearing as a symptom, Mantzouranis noted.
Children with asthma do better if they are treated earlier rather
than later, she said, and doctors who don't ask about throat clearing
symptoms may miss some early cases of the condition, she said.
"It is important to start treatment
early, because the prognosis is better," Mantzouranis explained.
"I would definitely add that (question
about throat clearing) to my standard questions for asthma," she
According to the American Lung
Association, asthma is the leading serious, chronic illness in
childhood, diagnosed in at least 7.7 million people younger than
18 in the US alone.
While wheezing and coughing are
considered common symptoms of asthma, other symptoms that also
signal the disease has arrived may be less recognized, Mantzouranis
and her colleagues note.
In an interview, Mantzouranis explained
that she began to suspect that throat clearing could be a sign
of asthma when some parents of children being treated for asthma
reported that their children had also stopped constantly clearing
their throats, a habit they had thought of as a "tic."
To determine whether throat clearing
was a sign of early asthma, the authors looked at questionnaires
given to the parents of 2,609 children aged between three and
five years old who attended a daycare center. The questionnaires
asked parents about typical symptoms of asthma and included one
additional query: "does your child have a habit of clearing his
or her throat often?"
Almost 18 percent of the children
had been diagnosed with asthma during the previous year, and another
24 percent had been told they had the disease prior to the previous
year, Mantzouranis and her colleagues report.
Parents of 106 children said they
were frequent throat clearers, 61 of whom had never been diagnosed
with asthma, nor had any symptoms of the condition.
To test whether these supposedly
asthma-free children did, in fact, have the disease, the researchers
measured lung function in 30 of the youngsters old enough to perform
This test revealed that these children,
on average, had reduced lung function. After doctors gave them
treatment for asthma, however, both their throat clearing and
lung function improved.
Seeing an improvement in symptoms
after receiving asthma medication is "consistent with the diagnosis
of clinically unrecognized asthma," Mantzouranis and her colleagues
Mantzouranis explained that children
with asthma have sensitive airways that react poorly to different
stimulants. In many children, this exposure leads to coughing
or wheezing. But in others with a less severe form of the condition,
their reaction is not strong enough to cause a cough or wheeze,
and exposure to a stimulant may result in simple throat clearing,
SOURCE: The New England Journal
of Medicine 2003;348:1502-1503.
Reference Source 89