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International Consensus (ICON) on Pediatric Asthma

Asthma is the most common chronic respiratory disease in childhood throughout the world. It most often starts early in life and has various clinical presentations over time. One such presentation in toddlers is ‘wheeze’ that may result from a  number of different conditions. Although around half of preschool wheezers become asymptomatic by school age irrespective of treatment, asthma symptoms may persist, often for life, especially in allergic and more severe cases. Common exposures such as tobacco smoke, air pollution, and respiratory infections may trigger symptoms and contribute to the morbidity and occasional mortality. Moreover, the impact of asthma on the quality of life of patients, as well as its cost, is very high. Therefore, appropriate asthma management may have a major impact on the quality of life of patients and their families, as well as on public health. Currently, primary prevention is not possible. Nevertheless, in established disease, control can be achieved with appropriate treatment, education, and monitoring in most children.

In children, asthma often presents with additional challenges not all of which are seen in adults, because of the maturing of the respiratory and immune systems, natural history, scarcity of good evidence, difficulty in establishing the diagnosis and delivering medications, and a diverse and frequently unpredictable response to treatment. It is therefore not surprising that several guidelines and/or consensus documents are available to support medical decisions on pediatric asthma.

The International Collaboration in Asthma, Allergy and Immunology (iCAALL), formed in 2012 by the EAACI, AAAAI, ACAAI, and WAO, created an International Consensus on (ICON) Pediatric Asthma. The purpose of this document is to provide a concise reference for pediatric asthma management.