DISCUSSION
In our study, the prevalence of raised AEC was 28.1% and IgE levels in
bronchiolitis (38.5%). RSV antigen was 35.4% as a causative factor and
the proportion and occurrence of wheeze among IgE positive patients was
45.9%
Age distribution:
In our study among 96 subjects, 55% fall under 2-6 months and 39% from
7-12 months. This is consistent with previous study by Chatterjee et al,
Siguris et al, Jartti et al 4 in which bronchiolitis
was associated with lower age group (2-6 months)
Gender:
In our study out of 96 subjects, bronchiolitis was more common in males
(60%) compared to females. Similar results given by Boezen Hm, Jansen
If et al 3 boys had more risk of developing
bronchiolitis than girls.
Incidence of RSV brochiolitis
In our study, RSV infection of 35.4% had high statistical significance.
Similar studies conducted by Soham gupta, rajni et al
7 who reported RSV infection among 22% of children.
Broor et al 8reported 30% bronchiolitis with
causative agent as RSV. We used amplification technique Reverse
transcriptase RT-PCR. This was supported by Javed Akhtar etal
9.
Chest Xray in bronchiolitis:
In our study 36% of children had hyper inflated lungs which is similar
to Javed akhtar et al 9stated 20-25% had
hyperinflated lungs.
IgE levels in bronchiolitis:
According to Stephen et al 10 measured IgE levels in
32 subjects. In his study 35% of them had IgE levels more than 95th
percentile. Among 32 subjects, 17 were RSV positive. In our study,
38.5% had raised igE levels and among 96 subjects, 34 (35.4%) were RSV
positive. But it was statistically not significant.
Similar study by Welliver et al 11 had 72 infants with
RSV bronchiolitis more than 25 subjects showed raised IgE levels. And
among them 17 had wheeze on follow up. In our study, among the raised
IgE levels 37 subjects, 45% (17 subjects) of them acquired wheeze.
Similar study was conducted by Singuris et al 12
positive IgE test was seen in 32% of RSV bronchiolitis and 23% of them
developed wheeze.
Eosinophils in bronchiolitis:
Kostas N. Priftis, Athina Papadopoulou 10 et al found
raised eosinophil level was significant in bronchiolitis. This was
similar to our study in which though the raise is low it was
statistically significant.
Prevention is by immunoprophylaxis (Palivizumab) and recommendation of
breastfeeding.
CONCLUSION:
-
With regard to age distribution, higher incidence of bronchiolitis is
seen in infant population 2-6 months.
-
Higher incidence in males than female gender.
-
Prevalance of increased AEC 27 (28.1%) they were correlated with age
and is found to have high statistical significance.
-
Prevalance of IgE in bronchiolitis 37 (38.5%) but did not have
statistical significance.
-
RSV antigen as a causative factor was 34 (35.4%) and had high
statistical significance.
-
The occurrence of wheeze was also analysed and was found to be
statistically significant.
-
The proportion of occurrence of wheeze among 46 positive patients was
45.9% .Out of increased IgE levels in 31 patients 17 had wheeze on
follow up.
-
Out of 27 raised AEC, 10 had wheeze on follow up.
-
Among normal patients 5 had wheeze.
-
Out of 8, who have both IgE and AEC raised, 3 had wheeze on follow up.
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