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Astma hos barn <12 år

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Sakkunnig:
Definition: 
Heterogen sjukdom med inflammation i luftvägar som leder till sammandragning av luftvägarna och hyperreaktivitet (överdrivet kontraktilt svar vid diverse stimuli).
Förekomst:
Prevalensen är 5–7 % hos barn i skolåldern, 8–10 % under 15 år, incidensen är högst i småbarnsåren. Infektionsastma drabbar 15–20 % av 1 till 2-åringar.
Symtom:
Vanliga symtom är pipande/väsande andning; tung, ansträngd andning; natthosta; hosta eller pipande/väsande andning vid ansträngning; nedsatt ork/fysisk prestationsförmåga. Vid infektionsastma symtom som ovan, samt ofta långvarig hosta vid och i efterförloppet av en luftvägsinfektion. 
Kliniska fynd: 
Ibland spridda, högfrekventa ronki som har olika tonhöjd och längd. Vid mer allvarlig astma kan man finna ett tyst lungauskultationsfynd, nedsatt fysisk aktivitet, nedsatt förmåga att tala, tecken på dyspné, hög puls och nedsatt saturation (exacerbation av astma/akut astma ).
Diagnostik:
Lungfunktionsmätningar kan påvisa variabel luftvägsobstruktion. I första hand rekommenderas dynamisk spirometri , eventuellt kan PEF-mätningar  användas.
Behandling:
Behandlingen består av icke-farmakologiska åtgärder för att minska exponering av utlösande faktorer och farmakologisk behandling med antiinflammatoriska läkemedel och luftrörsvidgande läkemedel.
  1. Nationella riktlinjer för vård vid astma och KOL – Stöd för styrning och ledning (2018) 
  2. Läkemedelsverket. Läkemedelsbehandling vid astma. 2015:(26):3. 
  3. UpToDate . Olika kapitel om astma hos barn. (Hämtad 2016-08-04)
  4. Global Initiative for asthma , Pocket guide for asthma management and prevention 2019 (hämtad 2019-04-17)
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  • Hanna Sandelowsky, specialist i allmänmedicin, Capio Ringen Vårdcentral, Stockholm; Med dr, Karolinska Institutet, Stockholm
  • Remy Waardenburg, specialist i allmänmedicin, medicinsk redaktör Medibas