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Usefulness of impulse oscillometry and fractional exhaled nitric oxide in children with Eosinophilic bronchitis

Authors
 Yoon Hee Kim  ;  Kyung Won Kim  ;  Jiyoung Baek  ;  Hyun Bin Park  ;  Hyemi Kim  ;  Kyung-Joo Song  ;  Jae Myun Lee  ;  Myung Hyun Sohn  ;  Kyu-Earn Kim 
Citation
 Pediatric Pulmonology, Vol.48(3) : 221-228, 2013 
Journal Title
 Pediatric Pulmonology 
ISSN
 8755-6863 
Issue Date
2013
MeSH
Asthma/diagnosis ; Asthma/metabolism ; Asthma/physiopathology ; Biomarkers/metabolism ; Bronchial Provocation Tests ; Bronchitis/diagnosis* ; Bronchitis/metabolism ; Bronchitis/physiopathology ; Bronchoconstrictor Agents ; Bronchodilator Agents ; Case-Control Studies ; Child ; Diagnosis, Differential ; Eosinophils/metabolism ; Exhalation ; Female ; Humans ; Leukocyte Count ; Male ; Methacholine Chloride ; Nitric Oxide/metabolism* ; Oscillometry* ; Pulmonary Eosinophilia/diagnosis* ; Pulmonary Eosinophilia/metabolism ; Pulmonary Eosinophilia/physiopathology ; ROC Curve ; Sensitivity and Specificity ; Spirometry ; Sputum/metabolism
Keywords
Asthma/diagnosis ; Asthma/metabolism ; Asthma/physiopathology ; Biomarkers/metabolism ; Bronchial Provocation Tests ; Bronchitis/diagnosis* ; Bronchitis/metabolism ; Bronchitis/physiopathology ; Bronchoconstrictor Agents ; Bronchodilator Agents ; Case-Control Studies ; Child ; Diagnosis, Differential ; Eosinophils/metabolism ; Exhalation ; Female ; Humans ; Leukocyte Count ; Male ; Methacholine Chloride ; Nitric Oxide/metabolism* ; Oscillometry* ; Pulmonary Eosinophilia/diagnosis* ; Pulmonary Eosinophilia/metabolism ; Pulmonary Eosinophilia/physiopathology ; ROC Curve ; Sensitivity and Specificity ; Spirometry ; Sputum/metabolism
Abstract
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.
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/ppul.22631/abstract
DOI
10.1002/ppul.22631
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Microbiology (미생물학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Won(김경원) ORCID logo https://orcid.org/0000-0003-4529-6135
Kim, Kyu Earn(김규언)
Kim, Yoon Hee(김윤희) ORCID logo https://orcid.org/0000-0002-2149-8501
Park, Hyun Bin(박현빈)
Sohn, Myung Hyun(손명현) ORCID logo https://orcid.org/0000-0002-2478-487X
Lee, Jae Myun(이재면) ORCID logo https://orcid.org/0000-0002-5273-3113
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87230
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