A comparative study of bronchodilator reversibility with albuterol, between asthma symptomatic and asymptomatic children according to ISAAC questionnaire in Mexico City.

BACKGROUND: Asthma is an important childhood disease. Recent surveys of the International Study of Asthma and Allergies in Childhood (ISAAC) suggest that the prevalence of asthma is increasing but these surveys do not include any pulmonary tests to confirm the possible diagnosis of asthma. OBJECTIVE: To compare bronchodilator reversibility with the albuterol test in symptomatic and asymptomatic 6-7-year-old children with asthma participating in the ISAAC survey and living in Mexico City. PATIENTS AND METHODS: We performed an observational, descriptive, comparative, cross sectional study in children participating in phase 3b of the ISAAC study. According to the ISAAC questionnaire children were classified as asthma symptomatic or asymptomatic. Both groups had bronchodilator reversibility with the albuterol test, using the guidelines of the American Thoracic Society to confirm or rule out the diagnosis of asthma. RESULTS: The asymptomatic group had a baseline FEV1 of 1.70 +/- 0.34 l/sec (mean +/- SD) and an endpoint FEV1 of 1.76 +/- 0.42 l/sec; in the symptomatic group the respective values were 1.51 +/- 0.41 l/sec and 1.57 +/- 0.44 l/sec (p < 0.05). A positive reversibility test was found in 13/136 (9.6 %) children in the asymptomatic group and in 22/112 (19.6 %) children in the symptomatic group (p < 0.05). CONCLUSION: Because of its low sensitivity, bronchodilator reversibility cannot be considered a diagnostic tool to confirm diagnosis of asthma.

A comparative study of bronchodilator reversibility with albuterol, between asthma symptomatic and asymptomatic children according to ISAAC Questionnaire in Mexico City

Background: Asthma is an important childhood disease. Recent surveys of the International Study of Asthma and Allergies in Childhood (ISAAC) suggest that the prevalence of asthma is increasing but these surveys do not include any pulmonary tests to confirm the possible diagnosis of asthma. Objective: To compare bronchodilator reversibility with the albuterol test in symptomatic and asymptomatic 6-7-year-old children with asthma participating in the ISAAC survey and living in Mexico City. Patients and methods: We performed an observational, descriptive, comparative, cross sectional study in children participating in phase 3b of the ISAAC study. According to the ISAAC questionnaire children were classified as asthma symptomatic or asymptomatic. Both groups had bronchodilator reversibility with the albuterol test, using the guidelines of the American Thoracic Society to confirm or rule out the diagnosis of asthma. Results: The asymptomatic group had a baseline FEV1 of 1.70 ± 0.34 l/sec (mean ± SD) and an endpoint FEV1 of 1.76 ± 0.42 l/sec; in the symptomatic group the respective values were 1.51 ± 0.41 l/sec and 1.57 ± 0.44 l/sec (p < 0.05). A positive reversibility test was found in 13/136 (9.6 %) children in the asymptomatic group and in 22/112 (19.6 %) children in the symptomatic group (p < 0.05). Conclusion: Because of its low sensitivity, bronchodilator reversibility cannot be considered a diagnostic tool to confirm diagnosis of asthma (AU)

Introducción: El asma es una enfermedad infantil importante. Las encuestas recientes del Estudio Internacional sobre Asma y Alergias en la Infancia (ISAAC, por sus siglas en inglés) sugieren un aumento de la prevalencia del asma, si bien este instrumento de estudio no incluye ninguna prueba pulmonar para confirmar el posible diagnóstico de la enfermedad. Objetivo: Comparar la reversibilidad con tratamiento broncodilatador a base de albuterol entre niños asmáticos sintomáticos y asintomáticos según el estudio ISAAC, de edades comprendidas entre los 6 y 7 años y residentes en Ciudad de México. Pacientes y métodos: Se trató de un ensayo comparativo transversal, de carácter descriptivo y basa- do en la observación, realizado sobre niños que participaron en una encuesta de la fase 3b del ISAAC. Según el cuestionario del ISAAC, los niños se clasificaron como asmáticos sintomáticos o asintomáticos para asma. Ambos grupos fueron sometidos a la prueba de reversibilidad con tratamiento broncodilatador a base de albuterol, siguiendo las directrices de la Sociedad Torácica Americana, para confirmar o descartar el diagnóstico de asma. Resultados: El grupo asintomático presentó un FEV1 inicial de 1,70 ñ 0,34 l/seg (media ñ DE) y un FEV1 final de 1,76 ñ 0,42 l/seg; en el grupo sintomático, los valores respectivos fueron 1,51 ñ 0,41 l/seg y 1,57 ñ 0,44 l/seg (p < 0,05). En el grupo asintomático, 13 de 196 niños (el 9,6 por ciento) dieron positivo en la prueba de reversibilidad; en el grupo sintomático dieron positivo 22 de 112 niños (el 19,6 por ciento) (p < 0.05). Conclusión: La reversibilidad con tratamiento broncodilatador no puede considerarse una herramienta para confirmar el diagnóstico del asma debido a su bajo nivel de precisión (AU)