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Diagnostic value of exhaled nitric oxide in childhood asthma and allergy
Author(s) -
SachsOlsen C.,
Lødrup Carlsen K. C.,
Mowinckel P.,
Håland G.,
Devulapalli C. S.,
MuntheKaas M. C.,
Carlsen K.H.
Publication year - 2010
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/j.1399-3038.2009.00965.x
Subject(s) - exhaled nitric oxide , medicine , asthma , allergy , spirometry , confidence interval , cohort , population , pediatrics , gastroenterology , immunology , environmental health
Sachs‐Olsen C, Lødrup Carlsen KC, Mowinckel P, Håland G, Devulapalli CS, Munthe‐Kaas MC, Carlsen K‐H. Diagnostic value of exhaled nitric oxide in childhood asthma and allergy.
Pediatr Allergy Immunol 2010: 21: e213–e221.
© 2010 John Wiley & Sons A/S Fractional exhaled nitric oxide (FE NO ) has been proposed as a diagnostic test of asthma. We aimed to investigate in a population based birth cohort of children the usefulness of FE NO as a diagnostic tool. The 10‐yr follow up of the Environment and Childhood Asthma Study in Oslo included 616 children representative of the prospective birth cohort. Both FE NO (single breath technique) and skin prick test (SPT) were measured in 331, limited at the time by equipment availability. Structural parental interview, spirometry, methacholine challenge and exercise test were performed. FE NO was significantly elevated in children with current asthma (geometric mean 9.6 (95% confidence interval (CI) (6.9, 13.4) p.p.b.) compared with healthy children (5.8 (5.4, 6.3) p.p.b.; p < 0.001). FE NO was highest among children with current allergic asthma (asthma and positive SPT) (14.0 (8.9, 22.1) p.p.b.), whereas children with non‐allergic asthma (6.1 (4.0, 9.2) p.p.b.) had comparable FE NO levels to healthy children (p = 0.99). Allergic sensitization was most closely associated with FE NO . A FE NO cut‐off value of 20.4 p.p.b. had a high specificity (0.97), but a low sensitivity (0.41) and a Positive Likelihood Ratio of 16.1 for current allergic asthma. In the present childhood population‐based study, high FE NO levels were closely associated with current allergic asthma and not with current asthma without allergic sensitization. Estimating the individual predictive probability of having asthma by use of FE NO, improves the diagnostic utility of the test.