Affiliation:
1. Division of Allergy, Pulmonology and Cystic fibrosis, Department for
Children and Adolescents, University Hospital Frankfurt, Goethe-University,
Frankfurt, Germany
Abstract
Abstract
Objective Exercise-induced bronchoconstriction (EIB) occurs frequently in
children and adolescents and may be a sign of insufficient asthma control. EIB
is often evaluated by respiratory symptoms, spirometry, eNO measurement and
methacholine testing (MCT) instead of time consuming exercise test. Aim of this
study was to analyse the amount of patients for which an exercise challenge in a
cold chamber (ECC) was needed for a clear EIB diagnosis, to characterize EIB
phenotypes and the incidence of exercise induced laryngeal obstruction (EILO) in
a large cohort of patients with EIB.
Methods A retrospective analysis was performed in 595 children and
adolescents (mean age 12.1 years) with suspected EIB from January 2014 to
December 2018. Complete data sets of skin prick test, spirometry, eNO and MCT
were available from 336 patients.
Results An ECC to confirm the EIB diagnosis was performed in 125
(37.2%) of patients. Three EIB phenotypes were detected: group 1: EIB
without allergic sensitization (n=159); group 2: EIB with other than
house dust mite (HDM) sensitization (n=87) and group 3: EIB with HDM
sensitization (n=90). MCT and eNO showed significant differences between
the subgroups: An eNO>46 ppb and/or a MCT<0.1 mg
was found in 23.9% vs. 50.6% vs. 57.8% in group
1–3, respectively. Significantly more patients suffered from EILO in
group 1 compared to group 2 and 3 (n=13 vs. n=1).
Conclusion EIB without sensitization is as often as EIB with
sensitization. In patients without sensitization, EILO has to be considered as a
possible cause of symptoms during exercise.
Subject
Pediatrics, Perinatology and Child Health
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