Comorbidities of pediatric asthma: A narrative review

Background: Asthma is one of the most common persistent inflammatory respiratory disorders. Comorbidities are relatively common in asthma. The aim of this review study was to find comorbid disorders in children with asthma. Methods: For the purpose of this review, we searched databases including Scopus, Google scholar, PubMed, SID, Irandoc and up-to-date. Key words for the search included children asthma, comorbidity and pediatric asthma. There were no time limitations for the search. Full text articles in English language were included in this study. Results: Neuropsychiatric comorbidities were Attention-deficit/hyperactivity disorder (ADHD) (11.5%), oppositional defiant disorder (ODD) (10.7%), separation anxiety disorder (6.1%), social anxiety disorder (3.8%), specific phobias (2.3%), agoraphobia without panic (1.5%), (mild) manic episodes (1.1%), major depressive episodes (MDE) (0.8%), movement (tic) disorder (0.8%) and dysthymia (0.4%). The prevalence of sinusitis was 13% in children with asthma (17). Prevalence of asthma in chronic rhinosinusitis with polyposis (CRSwP) is 26-48%, but the prevalence of CRSwP in asthmatic patients is only 7%. Asthma was prevalent in 25-35% patients with allergic rhinitis, and rhinitis symptoms were present in 75-90% of asthmatic patients. Asthma and obstructive sleep apnea (OSA) commonly coexist. Snoring (49.5%), gastro-esophageal reflux disease (GERD) (46.3%), atopic dermatitis (27.3%), allergic sinusitis (20%) and food allergy (10.5%) were common in children with asthma. Conclusions: Our review has revealed that allergic rhinitis, gastroesophageal reflux, obesity, food allergy, obstructive sleep apnea, allergic conjunctivitis, chronic rhinosinusitis and psychological abnormalities are common comorbidities in children with asthma.