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Rhinitis, sinusitis and ocular disease – 2087. Usefulness of impulse oscilometry and fractional exhaled nitric oxide in children with eosinophilic bronchitis
Kim et al. World Allergy Organization Journal
Rhinitis, sinusitis and ocular disease - 2087. Usefulness of impulse oscilometry and fractional exhaled nitric oxide in children with eosinophilic bronchitis
Yoon-Hee Kim 0
Kyung-Won Kim 0
Myung-Hyun Sohn 0
Kyu-Earn Kim 0
0 Pediatrics, Yonsei University College of Medicine , Seoul , South Korea
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.
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.
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.
By IOS, the bronchodilator response of the EB and asthma
groups increased significantly compared to controls for
both reactance at 5 Hz ( X5) and reactance area ( AX)
(P < 0.0001). Cutoff values to distinguish EB from controls
were a X5 of -20% (sensitivity, 77.5%; specificity, 49.6%),
and AX of -30% (sensitivity, 75.0%; specificity, 46.0%),
when the FeNO is 20 ppb.
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.
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