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The use of fractional exhaled nitric oxide in investigation of work‐related cough in a hairdresser
Author(s) -
Pala Gianni,
Pignatti Patrizia,
Moscato Gianna
Publication year - 2011
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.20948
Subject(s) - medicine , exhaled nitric oxide , inhalation , sputum , ammonium persulfate , occupational asthma , asthma , chronic cough , spirometry , anesthesia , pathology , tuberculosis , chemistry , organic chemistry , polymerization , polymer
Abstract Background Occupational and environmental factors may be a cause of nonasthmatic eosinophilic bronchitis (NAEB). The diagnosis of occupational NAEB requires evidence of sputum eosinophilia. Nevertheless, a minority of patients are not able to produce suitable sputum specimens. Methods This case report describes a 25‐year‐old woman, working as a hairdresser since the age of 20 years and handling ammonium persulfate, who came under our observation for work‐related rhinitis and cough. Results A specific inhalation challenge with ammonium persulfate elicited dry cough, without any significant change in forced expiratory volume in 1 s (FEV 1 ). Sputum induction was unsuccessful both pre‐ and after specific inhalation challenge. Fractional exhaled nitric oxide (FeNO) values significantly increased after specific inhalation challenge, suggesting a diagnosis of occupational NAEB due to ammonium persulfate. Conclusions From this observation we suggest that FeNO measurement should be added to the investigation of work‐related cough during specific inhalation challenge, and may be considered as an alternative to induced sputum to evaluate bronchial inflammation when sputum collection is unavailable or unsuccessful. Am. J. Ind. Med. 54:565–568, 2011. © 2011 Wiley‐Liss, Inc.