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Usefulness of impulse oscillometry and fractional exhaled nitric oxide in children with Eosinophilic bronchitis
Author(s) -
Kim Yoon Hee,
Kim Kyung Won,
Baek Jiyoung,
Park Hyun Bin,
Kim Hyemi,
Song KyungJoo,
Lee Jae Myun,
Sohn Myung Hyun,
Kim KyuEarn
Publication year - 2013
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.22631
Subject(s) - medicine , exhaled nitric oxide , spirometry , asthma , airway , bronchial hyperresponsiveness , airway obstruction , gastroenterology , cardiology , pulmonary function testing , anesthesia , respiratory disease , lung
Background Eosinophilic bronchitis (EB) is a common cause of chronic cough. Although EB shares many immunopathologic features with asthma, it does not show airway hyperresponsiveness or reversible airway obstruction by spirometry. Objective Compared to healthy children without pulmonary disease, we hypothesized that EB patients would demonstrate abnormal pulmonary function and inflammation with impulse oscillometry (IOS) and fractional exhaled nitric oxide (FeNO), which are more sensitive tests of these parameters than spirometry. Methods A total of 232 children with asthma, 109 with EB, and 115 control subjects were enrolled. We compared pulmonary function parameters and FeNO levels among the three groups. Additionally, we designated a screening cutoff value of FeNO combined with IOS parameters to distinguish EB from the control group, and identify which children with EB have more asthmatic characteristics. Results By IOS, the bronchodilator response of the EB and asthma groups increased significantly compared to controls for both reactance at 5 Hz (Δ X5) and reactance area (Δ AX) ( P < 0.0001). Cutoff values to distinguish EB from controls were a Δ X5 of −20% (sensitivity, 77.5%; specificity, 49.6%), and Δ AX of −30% (sensitivity, 75.0%; specificity, 46.0%), when the FeNO is 20 ppb. Conclusions Reversible airway obstruction in IOS and elevated FeNO levels can be detected in children with EB. This would support that EB in children shows airway characteristics similar to those of asthma, and that a continuum exists between asthma and EB. Pediatr Pulmonol. 2013; 48:221–228. © 2012 Wiley Periodicals, Inc.