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Thorax. 2010 Sep;65(9):801-7. doi: 10.1136/thx.2009.126912.

Prediction of asthma in symptomatic preschool children using exhaled nitric oxide, Rint and specific IgE.

Author information

1
Department of Pediatrics/Respiratory Medicine, Erasmus University, Rotterdam, The Netherlands.

Abstract

RATIONALE:

For clinicians it remains very difficult to predict whether preschool children with symptoms suggestive of asthma will develop asthma in later childhood.

OBJECTIVE:

To investigate whether measurement of fraction of exhaled nitric oxide (FE(NO)), interrupter resistance (Rint) or specific immunoglobulin E (IgE) in 4-year-old children with suggestive symptoms can predict asthma symptoms up to age 8 years.

METHODS:

Children were recruited from the PIAMA birth cohort. All children with symptoms suggestive of asthma at age 3 or 4 years, who were invited for medical examination at age 4 (n=848), were eligible. Associations of FE(NO) (n=308), Rint (n=482) and specific IgE (n=380) at 4 years with wheezing and asthma at the ages of 5-8 years were assessed using repeated measurement analyses. The added predictive value of these objective tests was then investigated by including parameters for clinical history in the model.

RESULTS:

FE(NO) and specific IgE measured at 4 years were associated with wheezing and asthma at 8 years. Both tests also remained significant predictors after mutual adjustment and adjustment for clinical history: OR on wheezing at 8 years for FE(NO) ((10)log-scale, per IQR) 1.6 (95% CI 1.1 to 2.2) and for specific IgE 2.8 (95% CI 1.9 to 4.1). Rint was significantly associated with wheezing at age 6, but not at 7 and 8 years.

CONCLUSIONS:

In preschool children with symptoms suggestive of asthma, both FE(NO) and specific IgE measured at age 4, but not Rint, improved the prediction of asthma symptoms until the age of 8 years, independent of clinical history.

PMID:
20805175
DOI:
10.1136/thx.2009.126912
[Indexed for MEDLINE]

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