title: Clinical findings associated with abnormal lung function in children aged 3-26 months with recurrent respiratory symptoms.
abstract: OBJECTIVE
  To evaluate whether there are any associations between parentally reported symptoms, clinical findings and lung function in young children with recurrent lower respiratory tract symptoms.
  
  
  METHODS
  In 2000-2003, 148 children, aged 3-26 months, with recurrent lower respiratory tract symptoms underwent physical examination, investigation of a chest radiograph, whole body plethysmography and skin prick testing to common food and inhalant allergens.
  
  
  RESULTS
  Lung function was considered abnormal (i.e. functional residual capacity z-score of > or =1.65 and/or specific conductance z-score of < or =-1.65) in 83 (56%) children. Findings of increased work of breathing (p < 0.001) and nonspecific noisy breathing sounds (p < 0.001) in the physical examination, as well as an abnormal chest radiograph (p = 0.028) were independently associated with abnormal lung function, explaining up to 34% of the variation in lung function. In contrast, parentally reported respiratory symptoms, environmental exposures or atopic trait were not associated with lung function abnormalities.
  
  
  CONCLUSIONS
  The results of this study emphasize the importance of the meticulous clinical examination in the evaluation of early childhood respiratory disorders. As physical examination alone cannot predict lung function abnormalities reliably in preschool children with troublesome respiratory symptoms, lung function testing may be considered in such patients to obtain additional objective information.
authors.affiliation: Department of Allergology, Helsinki University Central Hospital, Helsinki, Finland. anna.pelkonen@hus.fi
authors.forename: A S
authors.initials: AS
authors.lastname: Pelkonen
authors.forename: A
authors.initials: A
authors.lastname: Kotaniemi-Syrjänen
authors.forename: K
authors.initials: K
authors.lastname: Malmström
authors.forename: L P
authors.initials: LP
authors.lastname: Malmberg
authors.forename: M J
authors.initials: MJ
authors.lastname: Mäkelä
mesh_terms: D002675:Child, Preschool; D003371:Cough / Q000209:etiology*; D004417:Dyspnea / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010993:Plethysmography, Whole Body; D011859:Radiography; D012008:Recurrence; D012129:Respiratory Function Tests; D012135:Respiratory Sounds / Q000209:etiology*; D012140:Respiratory Tract Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D012882:Skin Tests