Abstract

Introduction

Asthma is a heterogenous disease, usually characterized by chronic airway inflammation. It is defined by a history of respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough that vary overtime and in intensity, together with variable expiratory airflow limitation⁽¹⁾. According to Global Initiative for Asthma (GINA 2019), acute asthma is characterized by worsening of symptoms and lung function from patient’s usual status. Asthma is one of the most commonly encountered diseases in clinical practice. The true burden of asthma in India is unknown. Indian asthmatics have a high frequency of reported exacerbations leading to substantial limitations of daily activities, lung function impairment, reduced quality of life and an adverse socioeconomic burden. Asthma insights and management was conducted in 9 countries in the Asia pacific region (AP-AIM study) including India in 2011. According to the study, asthmatics reported 8.4 exacerbations per year, each lasting a mean of 4days. Nearly in India, 78% of asthmatics reported missing work/ school due to their asthma in the year 2018. Productivity of asthmatics fell from 70% to 35% on the day with worst symptoms of asthma⁽¹⁾. Symptoms and airflow limitation may resolve spontaneously or in response to medication and may sometimes be absent for weeks or months at a time. Some patients experience episodic exacerbations of asthma that may be life threatening and carry a significant burden to them and the community. Airway hyper responsiveness and chronic airway inflammation usually persist, even when symptoms are absent or lung function is normal, but may normalize with treatment.^(1,2,3,4) Bronchial asthma is a major cause of morbidity and mortality among the pediatrics age group. Male: Female ratio of asthma in children is2:1, but in adults the ratio is 1:1. The prevalence of asthma has been increasing rapidly in westernized and industrialized countries^(1,2,3,4). Anemia associated with acute infection occurs more commonly in children than adults. Iron deficiency exerts adverse effect on immune response and alters the metabolism and growth of pathogens^(6,7,8). Anemia was suggested to be a risk factor in exacerbation of asthmatic attack because Hemoglobin facilitates oxygen and carbon dioxide transport, carries and inactivates nitric oxide and act as buffer. Hemoglobin in blood is mainly responsible for stabilizing the oxygen pressure in blood and tissues^(8,9). It has already been reported that low Hemoglobin impairs tissue oxygenation and acts as an independent risk factor developing LRTI in children. Since anemia has been shown to be a risk factor for LRTI, this descriptive study aims to assess the incidence of iron deficiency anemia in asthmatic pediatric patients in supporting the clinical findings at Department of Pediatrics, Grant Medical College and Sir JJ Group of Hospitals Mumbai, Maharashtra, India and is planned to determine serum iron level in children of bronchial asthma ^(8,9).