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I do NOT like FA questions!

8y/o boy says since an upper respiratory infection 4 months ago, he has atatcks characterized by wheezing and shortness of breath which resolves usually after one hour, wants to know what is wrong with her son.the only lab test is high eosinophilia








well between given choices asthma( charactristics of episods) is the answer ,,but my question is ;

is it an intrinsic asthma caused by respiratory infection? if yes why do we have eosinophilia? cause only the extrinsic asthma is immune mediated and we have increased in IgE AND eosinophis not intrinsic ones.

please share your thought



i found this might be the snwer to my question!

Kids who have had bronchiolitis may be more likely to develop asthma later in life, but it's unclear whether the illness causes or triggers asthma, or whether children who eventually develop asthma were simply more prone to developing bronchiolitis as infants. Studies are being done to clarify the relationship between bronchiolitis and the later development of asthma



There is a theory that Respiratory Syncytial Virus (RSV) can contribute to the development of asthma. Especially in children any lower respiratory tract infection that occur early on in life and has been recurrent -----could produce enough trauma to the tract--- to cause asthma later
Also to answer the question on eosinophil--- Eosinophils can go up in people with non allergic asthma too.

- j. Iyer


if you went back to esinoghilia in the second page of hematology FA there you'd find 5 causes of esinophilia among them is asthma, the exact mechanism I can't explain but memorization saves sometimes!!!



It is generally thought that eosinophils will increase only in allergic asthma. So when we think of non allergic causes we think eosinophils should be normal. But even in non allergic types there is activation of our immune system through a susbstance called Neopterin.
Neopterin is synthesized by human monocyte-derived macrophages upon stimulation with interferon .Their levels are lower in allergic asthmatic patients when compared with non-allergic asthmatic patients.
I will be glad if anyone has more inputs on this

_ Dr. J. Iyer

Edited by janeiyer on May 03, 2010 - 7:54 AM

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