Features of severe asthma in young children from Romania.

Asthma is the most frequent chronic disease of childhood. In spite of significant improvement of treatment options and diagnostic tools, asthma remains in many patients uncontrolled. The term of "severe asthma" seems to be rather a large umbrella for a heterogeneous group of diseases. This paper is presenting our experience in two respiratory disease clinics that evaluate asthmatic children. Current study was designed to test an algorithm for daily practice in a special group of patients: children with previously diagnosed asthma or recurrent-wheezing, evaluated by family physician or pediatrician as severe disease ("Asthma Decalogue in Children"). Out of 313 referrals (during a six months inclusion time) we had 202 children completing study per-protocol. 49 (22.69%) had severe disease, but only 8 had severe asthma (3.7% of total patients and 18.6% of severe patients). They were older, with less male predominance and with more frequent rhino-conjunctivitis and D vitamin deficiency than other asthmatic children with less severe disease. Asthma Decalogue in Children seems to be an efficient tool to differentiate severe asthma from the rest of children with reactive airway diseases.