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Diagnostic value of exhaled nitric oxide in childhood asthma and allergy

Diagnostic value of exhaled nitric oxide in childhood asthma and allergy 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 (FENO) has been proposed as a diagnostic test of asthma. We aimed to investigate in a population based birth cohort of children the usefulness of FENO 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 FENO (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. FENO 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). FENO 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 FENO levels to healthy children (p = 0.99). Allergic sensitization was most closely associated with FENO. A FENO 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 FENO 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 FENO, improves the diagnostic utility of the test. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Pediatric Allergy and Immunology Wiley

Diagnostic value of exhaled nitric oxide in childhood asthma and allergy

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References (48)

Publisher
Wiley
Copyright
© 2010 John Wiley & Sons A/S
ISSN
0905-6157
eISSN
1399-3038
DOI
10.1111/j.1399-3038.2009.00965.x
pmid
21083852
Publisher site
See Article on Publisher Site

Abstract

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 (FENO) has been proposed as a diagnostic test of asthma. We aimed to investigate in a population based birth cohort of children the usefulness of FENO 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 FENO (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. FENO 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). FENO 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 FENO levels to healthy children (p = 0.99). Allergic sensitization was most closely associated with FENO. A FENO 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 FENO 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 FENO, improves the diagnostic utility of the test.

Journal

Pediatric Allergy and Immunology – Wiley

Published: Feb 1, 2010

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