Sequelae of neonatal convulsions. Study of 112 infants.

Eosinophilic inflammation represents the pathophysiologic background of severe asthma in the majority of these patients. The best tool for assessing eosinophilic inflammation in severe asthma (blood or sputum eosinophils, Fractional exhaled Nitric Oxide [FeNO]) is still poorly defined, as well as whether these biomarkers are associated with different clinical severity features. 77 patients with severe asthma, after a long follow-up in order to optimize treatment, underwent blood/induced-sputum eosinophils and FeNO measurements. Patients were in a stable phase and under treatment with high dose ICS-LABA combination frequently associated with other controllers. In a multivariate/univariate analysis, risk factors for the greater number of exacerbations observed in the previous year were tested. Blood, sputum and exhaled air biomarkers were associated with at least one exacerbation. Instead, patients with exacerbations>3 in the previous year were associated with sputum eosinophils>50% but not with blood eosinophils or FeNO levels. In conclusion, blood eosinophils and FeNO levels may select severe asthmatics with>1 exacerbations in the previous year, while high sputum eosinophilia only seems to select patients with frequent exacerbations.