Diagnosis of asthma in childhood

Asthma is the commonest chronic
 illness and one of the most dangerous diseases 
in childhood. Paradoxically, it is often recognized late, and the treatment is frequently incorrect or inadequate. The author deals with the 
causes and consequences of incorrect diagnostic approach to the asthmatic child. Some 
guidelines are presented for recognition of asthmatic illness and for differentiation of asthma 
from other chronic and recurrent respiratory 
illnesses. The importance of history taking – this
 nearly forgotten medical art – is stressed, as
 accurate and reliable historical data are the
 cornerstones of final diagnosis. Some differential diagnostic clues are discussed. In older
 children, the diagnosis of asthma, based on two 
main features of the disease: reversible obstruction and increased responsiveness of the tracheobronchial tree, is confirmed by simple lung 
function tests. This obviates the need for evaluating the patient by a chest x-ray, skin tests and
 other allergologic tests. The importance of early 
treatment is underlined. Because of its high
incidence asthma should be dealt with in primary health centres. General practitioners and 
physicians working in preschool and school
child care centres – being paediatricians or not 
- should be involved with the management of
 this disease. It is therefore of great importance
 that medical undergraduates – future physicians – familiarize themselves with proper evaluation and treatment of asthmatic children.