PEDIATRICS Vol. 82 No. 2 August 1988, pp. 281-282
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Asthma

THOMAS F. PLAUT MD1, KATHY L. CHRISMER MD1, DAVID R. MARSH MD1, DAVID N. GOTTSEGEN MD1, and EMLEN H. JONES MD1

1 Northeast Permanente Medical Group, Box 841, Amherst, MA 01004

In Reply.—

We agree with Drs Smith and Melton that (1) asthma can occur in children less than 1 year of age. We have made this diagnosis in a number of infants. Our youngest patient had repeated respiratory symptoms responsive to bronchodilators at 3 months of age; (2) all children with asthma do not wheeze. The sick child with tachypnea or retractions may have no wheeze because the obstruction of many bronchioles is complete. This child will often begin to wheeze after treatment partially opens some airways (Am J Asthma Allergy Pediatricians 1987;1:49-50).