Diagnostic value of exhaled nitric oxide in childhood asthma and allergy

Pediatric Allergy and Immunology - Tập 21 Số 1-Part-II - 2010
Christine Sachs‐Olsen1, Kai‐Håkon Carlsen2,3, Petter Mowinckel3, Geir Håland3, Chandra Sekhar Devulapalli4, Monica Cheng Munthe‐Kaas3, Kai‐Håkon Carlsen2,1
1Voksentoppen, Department of Paediatrics, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
2Faculty of Medicine, University of Oslo, Oslo, Norway
3Department of Paediatrics, Oslo University Hospital Ullevål, Oslo, Norway
4Department of Paediatrics, Ringerike Hospital, Hønefoss, Norway

Tóm tắt

Sachs‐Olsen C, Lødrup Carlsen KC, Mowinckel P, Håland G, Devulapalli CS, Munthe‐Kaas MC, Carlsen K‐H. Diagnostic value of exhaled nitric oxide in childhood asthma and allergy.
Pediatr Allergy Immunol 2010: 21: e213–e221.
© 2010 John Wiley & Sons A/SFractional exhaled nitric oxide (FENO) has been proposed as a diagnostic test of asthma. We aimed to investigate in a population based birth cohort of children the usefulness of FENO as a diagnostic tool. The 10‐yr follow up of the Environment and Childhood Asthma Study in Oslo included 616 children representative of the prospective birth cohort. Both FENO (single breath technique) and skin prick test (SPT) were measured in 331, limited at the time by equipment availability. Structural parental interview, spirometry, methacholine challenge and exercise test were performed. FENO was significantly elevated in children with current asthma (geometric mean 9.6 (95% confidence interval (CI) (6.9, 13.4) p.p.b.) compared with healthy children (5.8 (5.4, 6.3) p.p.b.; p < 0.001). FENO was highest among children with current allergic asthma (asthma and positive SPT) (14.0 (8.9, 22.1) p.p.b.), whereas children with non‐allergic asthma (6.1 (4.0, 9.2) p.p.b.) had comparable FENO levels to healthy children (p = 0.99). Allergic sensitization was most closely associated with FENO. A FENO cut‐off value of 20.4 p.p.b. had a high specificity (0.97), but a low sensitivity (0.41) and a Positive Likelihood Ratio of 16.1 for current allergic asthma. In the present childhood population‐based study, high FENO levels were closely associated with current allergic asthma and not with current asthma without allergic sensitization. Estimating the individual predictive probability of having asthma by use of FENO, improves the diagnostic utility of the test.

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Tài liệu tham khảo

10.1111/j.1399-3038.2005.00239.x

10.1016/S0140-6736(94)90931-8

10.1152/physrev.00034.2003

10.1007/BF01957156

10.1016/S0140-6736(94)90935-0

10.1136/thorax.56.11.857

10.1002/ppul.20417

10.1034/j.1399-3038.2002.00066.x

10.1002/ppul.10377

10.1183/09031936.02.00285302

Petsky H, 2008, Tailored interventions based on exhaled nitric oxide versus clinical symptoms for asthma in children and adults, Cochrane Database Syst Rev, 2, CD006340

10.1016/S0140-6736(00)02842-7

10.1164/ajrccm.158.4.9710091

10.1164/ajrccm.159.1.9706006

10.1164/ajrccm.164.8.2101145

10.1136/thx.2005.056093

10.1111/j.1399-3038.2005.00220.x

10.1136/thorax.58.12.1048

10.1046/j.1365-2222.2003.01800.x

10.1183/09031936.05.00079604

10.1046/j.1365-2222.1999.00661.x

10.1164/rccm.200310-1376OC

10.1378/chest.123.3.751

10.1136/thorax.58.6.494

10.1136/thorax.57.7.586

10.1016/j.rmed.2005.03.039

10.1081/JAS-200057908

10.1034/j.1399-3038.13.s.15.2.x

10.1111/j.1398-9995.2005.00938.x

10.1056/NEJMoa052885

10.1164/rccm.200406-710ST

Dreborg S, 1993, Position paper. Allergen standardization and skin tests, Allergy, 48, 48S

10.1183/09031936.05.00034805

Zapletal A, 1987, Lung function in children and adolescents. Methods, reference values, Prog Respir Res, 22, 113

10.1136/thx.38.10.760

10.1164/ajrccm/136.6.1412

10.1053/rmed.2000.0809

10.1111/j.1399-3038.2005.00265.x

10.1378/chest.130.5.1319

10.1046/j.1365-2222.2003.01597.x

10.1111/j.1398-9995.2005.00740.x

10.1111/j.1398-9995.2005.00735.x

10.1164/ajrccm.164.11.2006165

10.1002/ppul.20927

10.1111/j.1365-2222.2005.02279.x

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Pediatric Allergy and Immunology

Tập 21 Số 1-Part-II

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