Exercise-induced bronchospasm diagnosis in children. Utility of combined lung function tests.
Pediatr Allergy Immunol
; 26(1): 73-9, 2015 Feb.
Article
em En
| MEDLINE
| ID: mdl-25444583
ABSTRACT
BACKGROUND:
The diagnosis of exercise-induced asthma or bronchospasm (EIB) is a complex dare in daily clinical practice. The consensus is that if bronchial hyper-responsiveness (BHR) is demonstrated in a patient with symptoms consistent with EIB, then that patient can be diagnosed with exercise-induced bronchospasm. The aim of this study was to determine which BHR test is the most efficient to diagnose EIB.METHODS:
Children under 16, without previous asthma diagnosis, or with stable asthma, complaining of asthma-like symptoms triggered by exercise were included. Bronchodilator, methacholine, mannitol, and exercise tests were performed on all patients, following established protocols. The performance of single and combined tests was determined.RESULTS:
Of 46 patients (median age 12 yr, ranged 8-16 y.o.) were recruited, 30 (70%) previously diagnosed of asthma. BHR was detected in 93.47% of the children. The exercise challenge test detected BHR in 11 of 46 (23.90%) patients, bronchodilator test in 10 of 46 (21.70%), mannitol in 36 of 45 (80%) and methacholine in 41 of 45 (91.11%). The total number of patients with BHR was detected using a combination of the methacholine and mannitol tests. A combination of the methacholine test performed first, followed by the mannitol test, was able to diagnose BHR in 100% of children with lower number of tests (n = 45) than if the order was reversed (n = 50).CONCLUSIONS:
Methacholine and mannitol tests detect BHR in most children with suspected EIB. Bronchodilator and exercise tests show a low positivity rate. A combination of the methacholine test, followed by the mannitol test, gives the highest return to identify BHR in children for the diagnosis of EIB.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Testes de Função Respiratória
/
Asma Induzida por Exercício
/
Hiper-Reatividade Brônquica
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
Limite:
Adolescent
/
Child
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Pediatr Allergy Immunol
Assunto da revista:
ALERGIA E IMUNOLOGIA
/
PEDIATRIA
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Espanha