FENO cannot replace MCT in suspected pediatric asthma

  • Keßler A & al.
  • Respir Med
  • 27 Aug 2019

  • International Clinical Digest
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Takeaway

  • Exhaled nitric oxide (FENO) is not acceptable as a substitute for methacholine challenge test (MCT) in children with suspected asthma.
  • However, if a child has a normal FENO and a negative skin prick test (SPT), odds are good that they do not have atopic asthma, these authors say. 

Why this matters

  • FENO has been proposed for use in adults to substitute for MCT in diagnosing asthma.

Key results

  • FENO values were higher in patients with atopic asthma (18; range, 5-89) ppb vs those with nonatopic asthma (7 [range, 5-36] ppb; P<.001 or atopia with no asthma ppb p>
  • FENO ≥15.5 ppb sensitivity for atopic asthma was 61.1%; its specificity was 64.9%.
  • FENO ≥6.5 ppb sensitivity for nonatopic asthma was 54.1%; specificity was 39.2%.

Study design

  • 222 children (134 with atopy per SPT), ages 5-17 years evaluated during a single visit with SPTENO, spirometry, and MCT.
  • Funding: None disclosed.

Limitations

  • Single center, small study, 1 measurement per test made.

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