Premium
Central airways stenosis in school‐aged children: differential diagnosis from asthma
Author(s) -
Linna O,
Hyrynkangas K,
Lanning P,
Nieminen P
Publication year - 2002
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2002.tb01661.x
Subject(s) - medicine , spirometry , asthma , stenosis , tracheal stenosis , cardiology , anesthesia
This study assessed the value of spirometry and chest X‐rays in the diagnosis of airways stenosis in the tracheal or laryngeal regions at school age. A series of 14 patients was studied. Six of them had vascular ring anomalies, four subglottic stenosis, two aberrant innominate artery, one tracheal stenosis and one a laryngeal web. Four patients were suffering from chronic cough and ten from dyspnoea, noisy breathing and cough upon physical exercise. Two had had their symptoms since infancy and five since 3–6 y of age, whereas seven had had their first symptoms at school age. Nine patients had previously been suspected of having asthma, and five of them had been using inhaled corticosteroids, one inhaled sodium cromoglycate and one peroral terbutaline without any effect. The ratio of forced expiratory volume in 1 s (FEV 1 ) to peak expiratory flow (PEF) was abnormally high in most of the patients. All six children with vascular ring anomalies also had an abnormal aortic configuration on a chest X‐ray, and narrowing of the trachea was seen in two of the four with subglottic stenosis. Two children had both chest X‐rays and spirometry values within the normal limits. Conclusion : The results show that children with stenosis in the laryngeal or tracheal region may not have their first symptoms until school age. Many patients are falsely suspected of having asthma. Simple spirometry and chest X‐rays will help the physician to make the correct diagnosis in these patients.