Hypertonic saline challenge tests in the diagnosis of bronchial hyperresponsiveness and asthma in children.

Hypertonic saline challenge tests in the diagnosis of bronchial hyperresponsiveness and asthma in children. Research Abstract Details 

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Hypertonic saline challenge tests in the diagnosis of bronchial hyperresponsiveness and asthma in children. Abstract Text:

The hypertonic saline challenge test is the recommended method to assess bronchial hyperresponsiveness in the International Study of Asthma and Allergies in Childhood (ISAAC). The sensitivity of this procedure to assess asthma symptoms, however, has been reported to vary among study centers. The purpose of our study was to evaluate the value of this provocation test in an epidemiological survey in children, and to relate the degree of bronchial hyperresponsiveness to the severity of asthma symptoms. All 11-13-year-old children from 16 randomly selected schools in Linköping, Sweden received a questionnaire regarding respiratory symptoms and allergic disease. Skin prick tests with eight inhalant allergens were performed. In addition, all children with wheeze over the past 12 months (current wheeze) and a random sample of children without current wheeze were invited to perform hypertonic saline provocation tests. A complete data set was available for 170 children, including 50 with and 120 without current wheeze. Bronchial hyperresponsiveness (BHR) was defined as at least 15% decline in FEV1. The degree of BHR was represented by the response/dose ratio, i.e. the fall in FEV1 divided by total dose of inhaled saline. The severity of asthma symptoms was classified by the number of wheezing episodes over the past 12 months. 'Asthma ever' was defined by a combination of symptoms in the questionnaires. Children with 'asthma ever' and current wheeze were considered as having current asthma. Current atopic asthma was defined as current asthma with at least one positive skin prick test. The sensitivity of the procedure to detect 'asthma ever', current asthma and current atopic asthma was 62, 61 and 83%, and the specificity 83, 81 and 60%, respectively. The positive challenge rate was 52, 34, 13 and 7% among current wheezers, previous wheezers, non-wheezers with a history of allergy and healthy children. The degree of bronchial hyperresponsiveness increased with the number of wheezing episodes. Thus, the median and range of the response/dose ratio were 4.8%/ml (2.1-14.8), 2.6%/ml (0.7-8.6) and 1.3%/ml (0.8-2.7), respectively, for children with >/= 4 episodes, 1-3 episodes and no wheezing episodes over the past 12 months (p<0.001). In conclusion, hypertonic saline provocation test is useful as a tool to detect asthma in epidemiological studies in children. The degree of bronchial hyperresponsiveness, as represented by the response/dose ratio, reflects the severity of asthma symptoms.

Hypertonic saline challenge tests in the diagnosis of bronchial hyperresponsiveness and asthma in children. Publishing Authors By Initials

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Hypertonic saline challenge tests in the diagnosis of bronchial hyperresponsiveness and asthma in children. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Pediatric allergy and immunology : official public

VOLUME: 13

Page Numbers: 361-7

Journal Abbreviation: Pediatr Allergy Immunol

ISSN: 0905-6157

DAY: 28

MONTH: Oct

YEAR: 2002

Hypertonic saline challenge tests in the diagnosis of bronchial hyperresponsiveness and asthma in children. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 9106718

Hypertonic saline challenge tests in the diagnosis of bronchial hyperresponsiveness and asthma in children. Keywords Mesh Terms:

KEYWORDS: Sweden

MESH TERMS: diagnostic use

Chemical & Substance for Abstract: Hypertonic saline challenge tests in the diagnosis of bronchial hyperresponsiveness and asthma in children. Information

Substance Name: Saline Solution, Hypertonic

Registry Number: 0

Grant and Affiliation Information for Hypertonic saline challenge tests in the diagnosis of bronchial hyperresponsiveness and asthma in children.

AFFILIATION: Department of Health and Environment, Division of Paediatrics, Faculty of Health Sciences, Linköping University, Sweden. xiama@ihm.liu.se

Country: Denmark

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MEDLINETA: Pediatr Allergy Immunol

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