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The correlation of adenosine challenge test results with subsequent clinical course among young children with suspected asthma: a retrospective cohort study
Author(s) -
Levin Gabriel,
Rottenstreich Amihai,
Picard Elie,
Avital Avraham,
Springer Chaim,
Cohen Shlomo
Publication year - 2019
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.24337
Subject(s) - medicine , asthma , retrospective cohort study , cohort , pediatrics , cohort study
Aim Our aim was to evaluate the correlation of Adenosine monophosphate challenge test (AMP‐PCW) results with the patients' subsequent clinical course. Methods We performed a 6‐year retrospective cohort study of young children with suspected asthma who underwent AMP‐PCW test. Results Fifty four children were included in the study (median age, 50.5 months; range, 26‐90). AMP‐PCW was positive in 35 (65%) children. During the 3‐year follow‐up period, among 22 of 35 patients in the positive AMP‐PCW group and among 17 of 19 in the negative AMP‐PCW group—prophylactic therapy was not changed. Prophylactic therapy was initiated or its dose was escalated in 12 of 13 (92.3%) of the children with a positive AMP‐PCW test compared to none of the children with a negative challenge test ( P < 0.001). Prophylactic therapy was discontinued in only one (7.6%) of the children with a positive test as compared to two (100%) of the children with a negative test ( P < 0.001). There were significantly fewer severe asthma exacerbations during a 3‐year follow‐up period after the challenge test as compared to the preceding 3‐year period both in children with a positive (from 34 to 9 total events, P = 0.01) or a negative challenge test (from 16 to 0 events P = 0.01). The severity of airway hyper responsiveness was found to associate with the number of severe asthma exacerbations ( P = 0.04) and with a diagnosis of asthma during the following 3 years ( P = 0.02). Conclusions AMP‐PCW test results correlates with the subsequent clinical course of young children with suspected asthma performing the test.