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. Author manuscript; available in PMC: 2012 Sep 1.
Published in final edited form as: Mt Sinai J Med. 2011 Sep;78(5):645–660. doi: 10.1002/msj.20285

Table 1.

Presentation and Risk Factors for Different Wheezing Phenotypes in Childhood

Type: Early Transient
Wheezing
Presentation:
Lung function diminished at birth
and remains reduced at age 6 and
11
Risk Factors:
  • Maternal smoking during pregnancy

  • Post-natal exposure to tobacco smoke

  • Prematurity

  • No family history of asthma or atopy

  • No peak flow variability or methacholine responsiveness

  • No elevated serum IgE or skin test reactivit

Type: Atopic Persistent
Wheezing
Presentation:
Normal lung function at birth with
diminished (lowest) lung function
at age 6 and 11
Risk Factors:
  • Maternal asthma, maternal smoking

  • Genetic pre-disposition for sensitization to aero-allergens

  • Allergic sensitization and chronic airway inflammation<1 year

  • Atopy, elevated serum IgE at 9 months of age and at age 6, but not in cord blood

  • Eczema, rhinitis apart from cold

  • Early onset wheezing and severe disease

  • Peak flow variability and methacholine responsiveness

Type: Non-atopic Persistent
Wheezing
Presentation:
Normal lung function at birth with
diminished lung function at age 6
Risk Factors:
  • Maternal smoking

  • Lower respiratory illnesses in the first 3 years

  • RSV before 3 years of age associated with wheeze at age 10

  • Peak flow variability but no methacholine responsiveness

Type: Late Onset Wheezing
Presentation:
Normal lung function at birth and
at age 6
Risk Factor:
  • Maternal asthma

  • No elevated IgE at 9 month of age