title: Bronchial hyperresponsiveness to 4.5% hypertonic saline indicates a past history of asthma-like symptoms in children.
abstract: SUMMARY. To evaluate the importance of a past history of asthma-like symptoms over a period of 2 years and current bronchial hyperreactivity (BHR), 538 randomly selected schoolchildren, initially aged 7-8 years, were examined. At yearly intervals, three standardized questionnaires, including items from the ISAAC panel, were answered by parents. Following the last questionnaire, BHR to 4.5% hypertonic saline (HS) was recorded. In survey 1, lifetime prevalence of asthma was 4.9%. During the 12-month period, prevalence of wheeze and dyspnea ranged between 9.3 and 5.2% (Survey 1) and 5.9% and 4.4% (Survey 2). Among children with wheeze or dyspnea in Survey 3, BHR (defined as a fall of baseline FEV(1) > or = 15%) was significantly more frequent (50.0% and 60.7%, respectively) than among children without these symptoms (12.8%, P < 0.001, and 12.8%, P < 0.001, respectively). The negative predictive value of BHR to have neither wheeze nor dyspnea was about 88% and did not vary throughout the study (Survey 1, 87%; Survey 2, 88%; Survey 3, 88%). The relative risk of showing BHR was significantly increased in children with wheeze (survey 2, odds ratio (OR) 3.0 (95% confidence interval (CI) 1.0-8.7)) or dyspnea (Survey 1: OR 5.9 (95% CI 1.9-18.5), Survey 3: 5.2 (1.7-16.2), but not in children with dry cough or nocturnal cough (data not shown). Wheeze and dyspnea occurred repeatedly in the same individuals with BHR in a high percentage of children (83.3% and 76.5%, respectively). In conclusion, there is a strong association between recent and previous dyspnea and current BHR, and it indicates intraindividual persistence of symptom history.
authors.affiliation: University Children's Hospital, Freiburg, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Strauch
authors.forename: T
authors.initials: T
authors.lastname: Neupert
authors.forename: G
authors.initials: G
authors.lastname: Ihorst
authors.forename: K
authors.initials: K
authors.lastname: Storm van's Gravesande
authors.forename: W
authors.initials: W
authors.lastname: Bohnet
authors.forename: B
authors.initials: B
authors.lastname: Hoeldke
authors.forename: W
authors.initials: W
authors.lastname: Karmaus
authors.forename: J
authors.initials: J
authors.lastname: Kuehr
mesh_terms: D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology; D016535:Bronchial Hyperreactivity / Q000175:diagnosis* / Q000503:physiopathology; D001985:Bronchial Provocation Tests; D002648:Child; D016001:Confidence Intervals; D003371:Cough / Q000175:diagnosis; D004417:Dyspnea / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D012135:Respiratory Sounds / Q000175:diagnosis; D012307:Risk Factors; D012462:Saline Solution, Hypertonic; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014797:Vital Capacity / Q000502:physiology
chemical_list: D012462:Saline Solution, Hypertonic