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Médecine thérapeutique / Pédiatrie

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Severe asthma in children: What diagnostic procedure? What is the place for anti-IgE treatment? Volume 20, issue 2, Avril-Mai-Juin 2017

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Author
CHRU de Lille, Hôpital Jeanne de Flandre, Pôle de pédiatrie, Unité de pneumologie et allergologie pédiatriques, 59037 Lille cedex, France
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Severe childhood asthma is now a clearly defined disease. Although infrequent, it is characterized by persistent symptoms, including severe exacerbations, some of them leading to hospitalization, strongly affects the quality of life, and generates a high health cost. Its management requires a rigorous step by step evaluation, with the aim to reinforce the diagnosis and to adapt an individualized treatment plan. This approach is based on the multidisciplinary skills of a center dedicated to severe childhood asthma. The latter has different characteristics from that of the adult. Allergy is a strong marker: early and multiple and/or unusual sensitizations, weight of the comorbidities. New treatments are emerging, as omalizumab (Xolair®) an anti-IgE biotherapy available in France since 2006. The objective of this review is to detail the diagnosis approach of severe asthma in children, to describe the specific features of the disease, and finally to review the data on the studies evaluating the impact of omalizumab in pediatric severe allergic asthma.