Asthmatic bronchitis is characterized by allergic affection mainly of medium and large diameter bronchi.

Aetiology and pathogenesis

Doctors describe atopic and infectious-allergic forms of the asthmatic bronchitis. In young children the sensitization to food, drug and bacterial allergens may become significant cause of the development of the asthmatic bronchitis. At more advanced age, the increased sensitivity to house, pollen, and fungal allergens plays the essential role. The development of atopic form of the asthmatic bronchitis is determined by IgE-mediated allergic reactions. In the pathogenesis of the infectious-allergic form of the asthmatic bronchitis the leading part is plaid by cellular-mediated immune pathologic reactions; however, in some children with this form of the disease doctors detect the participation of IgE-mediated mechanism. The development of the asthmatic bronchitis is promoted by hereditary predisposition to allergic reactions and diseases as well as recurrent viral and bacterial inflammatory diseases of respiratory system.

Clinical picture of asthmatic bronchitis

The basis for clinical manifestations of the asthmatic bronchitis is composed by the disorder of bronchial airway patency, but unlike the bronchial asthma the obstructive troubles of breathing in asthmatic bronchitis are less expressed or are not observed at all. The disease may be preceded by the allergic rhinitis, paroxysmal cough occurring more often at night, and the subfebrile rise of body temperature. Then, an insignificant dyspnea of expiratory type appears; some children experience the breathlessness of a mixed type. At the top of the illness exacerbation, doctors detect significant amount of heterogeneous bubbling rales and moderate quantities of dry rales in the lungs. Above the lung area doctors detect bandbox resonance of the percussion sound. At the roentgenologic examination doctors find pattern attenuation in lateral lung areas and its accentuation in the medial areas. The acute period of the asthmatic bronchitis lasts from 10 to 25 days. The disease has the recurrent course. Some children with asthmatic bronchitis develop clinical manifestations of atopic dermatitis and nettle rash.
The diagnosis of asthmatic bronchitis is based on taking into account the data of the anamnesis and examination of the child, including carrying out of the allergic diagnostics.
The prognosis is favorable if the treatment is adequate and started early. The transition to bronchial asthma is possible in children with a polyvalent sensitization.

Treatment of asthmatic bronchitis

In all cases of the asthmatic bronchitis the elimination of significantly causal allergens is carried out. In the acute period of an asthmatic bronchitis doctors prescribe symptomatic preparations such as berotec, salbutamol, aminophylline, and mucolytic agents. For the prevention of the disease exacerbations doctors can use cromolyn sodium, zaditen, histaglobulin, allergoglobulin, and antiallergic immunoglobulin. Acupuncture, electro-acupuncture, laser therapy may be effective for the treatment. During the remission of the disease specific immune therapy with significantly causal allergens is carried out. The rehabilitation programs for children with the asthmatic bronchitis include observance of sparing allergic regimen, respiratory and physical exercises, massage of the thoracic, training, and sanatorium treatment.