Asthma and lower airway diseaseExhaled nitric oxide distinguishes between subgroups of preschool children with respiratory symptoms
Section snippets
Study population
This is a prospective cohort study with 391 young children less than 4 years of age consecutively undergoing assessment for respiratory symptoms at the University Children's Hospital Zürich, Switzerland, between 2000 and 2004. Exclusion criteria were a diagnosis of a specific respiratory disease such as cystic fibrosis, primary ciliary dyskinesia, interstitial lung disease, pneumonia, or tuberculosis and/or current upper airway infection or inability to obtain an appropriate FeNO measurement.
Results
Group 1 (children with cough) consisted of more girls (P = .023) and older children (P < .026) compared with groups 2 and 3. Allergic sensitization as assessed by RAST was more frequent in group 3 compared with groups 1 and 2. No differences between groups were noted for percentage of blood eosinophils or prenatal or postnatal passive smoke exposure. Less than 1/3 of the children were on current inhaled corticosteroid (ICS) treatment at the time of FeNO measurement, significantly more in groups
Discussion
We have shown that the measurement of exhaled NO differentiates between subgroups of young children less than 4 years of age with wheezy and nonwheezy respiratory symptoms. Children with frequent recurrent wheeze and a stringent asthma predictive index10 (group 3) showed significantly higher FeNO values than children with nonfrequent recurrent wheeze and a loose asthma predictive index (group 2) or nonwheezy children with chronic or recurrent cough (group 1). Although there was an overlap in
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2021, HeliyonCitation Excerpt :The procedure was performed according to the manufacturer's instructions and American Thoracic Society/European Respiratory Society (ATS/ERS) recommendations. Exhaled nitric oxide levels were classified as follows: a low level at less than 20 ppb; a normal level at 20–35 ppb; and a high level at greater than 35 ppb [26, 27]. Descriptive statistical analyses were used in this study to demonstrate demographic, clinical and laboratory data.
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2016, Pediatric Allergy: Principles and Practice: Third EditionExhaled nitric oxide as a diagnostic tool for wheezing in preschool children: A diagnostic accuracy study
2016, Respiratory MedicineCitation Excerpt :Two studies that did not determine the cut-off point for wheezing, but differences between the central and dispersion measurements among groups also show results consistent with those observed in our population. In a cut-off with children under four years old in Switzerland, the mean of FENO in the wheezing with a low probability of asthma was 6.4 ppb, and in the wheezing with high probability of asthma was 11.6 ppb [26]. In a study with Korean preschoolers, those transient wheezing had a mean FENO value of 11.5 ppb and 14.4 ppb for persistent wheezing [28].
Supported by an unrestricted grant by GlaxoSmithKline Switzerland.
Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.