Objectives: Chest high-resolution computed tomography (HRCT) is conditionally recommended to rule out conditions that mimic or coexist with severe asthma in children. However, it may provide valuable insights into identifying structural airway changes in pediatric patients. This study aims to develop a machine learning-based chest HRCT image analysis model to aid pediatric pulmonologists in identifying features of severe asthma.
Methods: This retrospective case-control study compared children with severe asthma (as defined by ERS/ATS guidelines) to age- and sex-matched controls without asthma, using chest HRCT scans for detailed imaging analysis. Statistical analysis included classification trees, random forests, and conventional ROC analysis to identify the most significant imaging features that mark severe asthma from controls.
Results: Chest HRCT scans differentiated children with severe asthma from controls. Compared to controls (n = 21, mean age 11.4 years), children with severe asthma (n = 20, mean age 10.4 years) showed significantly greater bronchial thickening (BT) scores (p < 0.001), airway wall thickness percentage (AWT%, p < 0.001), bronchiectasis grading (BG) and bronchiectasis severity (BS) scores (p = 0.016), mucus plugging, and centrilobular emphysema (p = 0.009). Using AWT% as the predictor in conventional ROC analysis, an AWT% ≥ 38.6 emerged as the optimal classifier for discriminating severe asthmatics from controls, with 95% sensitivity, specificity, and overall accuracy.
Conclusion: Our study demonstrates the potential of machine learning-based analysis of chest HRCT scans to accurately identify features associated with severe asthma in children, enhancing diagnostic evaluation and contributing to the development of more targeted treatment approaches.
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http://dx.doi.org/10.1002/ppul.27183 | DOI Listing |
Pulm Ther
December 2024
Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA.
Introduction: Asthma is a complex condition characterized by airway inflammation. Interleukin-6 (IL-6) plays a significant role in asthma pathogenesis through its effects on T cells and its association with pro-inflammatory responses. Both lung and circulating IL-6 levels are elevated in asthma.
View Article and Find Full Text PDFProc (Bayl Univ Med Cent)
August 2024
North Texas Allergy and Asthma Associates and Division of Allergy/Immunology, Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas, USA.
Multiple biologic agents are approved for the treatment of severe persistent asthma not controlled by inhaled corticosteroid/beta-agonist therapy. Appropriate phenotyping can aid in picking the right biologic for the right patient. Here is a unique case of a patient with severe asthma and respiratory arrest, with fraction of exhaled nitric oxide >300 ppb whose asthma became completely controlled with dupilumab.
View Article and Find Full Text PDFHypomelanosis of Ito (HI), a neurocutaneous syndrome, is characterized by skin depigmentation and skeletal, muscular, central nervous system, cardiac, and renal manifestations. A wide variety of cutaneous manifestations besides depigmentation have been reported. Herein we describe a 23-year-old woman with HI whose extracutaneous symptoms included severe mental and motor impairment, convulsions, and deformity of the orofacial region.
View Article and Find Full Text PDFZhonghua Yu Fang Yi Xue Za Zhi
December 2024
Department of Clinical Laboratory, The Key Laboratory of Advanced Interdisciplinary Studies Center, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease,Guangzhou510120, China.
This study aims to analyze the differentiating factors between only allergic rhinitis and allergic rhinitis combined with other allergic diseases in pre-school children and to explore the impact of relevant family and maternal factors during pregnancy on pediatric allergic diseases.The study employed an epidemiological cross-sectional survey design, conducted from January to June 2022 at the Helong Street Health Service Center in Baiyun District, Guangzhou City, China. This cross-sectional investigation focused on 15 preschool education centers within the jurisdiction.
View Article and Find Full Text PDFZhonghua Yu Fang Yi Xue Za Zhi
December 2024
Respiratory Department, Shenzhen Children' s Hospital, Shenzhen518026, China.
To investigate the distribution characteristics and analyze the clinical significance of dermatophagoides pteronyssinus allergen components in children with allergic rhinitis and asthma in Shenzhen. This study was a cross-sectional study. The clinical data of children with allergic rhinitis and asthma induced by dust mites admitted to the allergy clinic of Shenzhen Children's Hospital from 2021 to 2024 were collected and the serum sIgE levels of dermatophagoides pteronyssinus, dermatophagoides farinae (Der p, Der f) and dermatophagoides pteronyssinus components (Der p 1, Der p 2, Der p 10, Der p 23) were detected by magnetic bead chemiluminescence method.
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