title: Usefulness of impulse oscillometry and fractional exhaled nitric oxide in children with Eosinophilic bronchitis.
abstract: BACKGROUND
  Eosinophilic bronchitis (EB) is a common cause of chronic cough. Although EB shares many immunopathologic features with asthma, it does not show airway hyperresponsiveness or reversible airway obstruction by spirometry.
  
  
  OBJECTIVE
  Compared to healthy children without pulmonary disease, we hypothesized that EB patients would demonstrate abnormal pulmonary function and inflammation with impulse oscillometry (IOS) and fractional exhaled nitric oxide (FeNO), which are more sensitive tests of these parameters than spirometry.
  
  
  METHODS
  A total of 232 children with asthma, 109 with EB, and 115 control subjects were enrolled. We compared pulmonary function parameters and FeNO levels among the three groups. Additionally, we designated a screening cutoff value of FeNO combined with IOS parameters to distinguish EB from the control group, and identify which children with EB have more asthmatic characteristics.
  
  
  RESULTS
  By IOS, the bronchodilator response of the EB and asthma groups increased significantly compared to controls for both reactance at 5 Hz (Δ X5) and reactance area (Δ AX) (P < 0.0001). Cutoff values to distinguish EB from controls were a Δ X5 of -20% (sensitivity, 77.5%; specificity, 49.6%), and Δ AX of -30% (sensitivity, 75.0%; specificity, 46.0%), when the FeNO is 20 ppb.
  
  
  CONCLUSIONS
  Reversible airway obstruction in IOS and elevated FeNO levels can be detected in children with EB. This would support that EB in children shows airway characteristics similar to those of asthma, and that a continuum exists between asthma and EB.
authors: Department of Pediatrics and Institute of Allergy, Severance Biomedical Science Institute, Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea.
authors: Yoon Hee
authors: YH
authors: Kim
authors: Kyung Won
authors: KW
authors: Kim
authors: Jiyoung
authors: J
authors: Baek
authors: Hyun Bin
authors: HB
authors: Park
authors: Hyemi
authors: H
authors: Kim
authors: Kyung-Joo
authors: KJ
authors: Song
authors: Jae Myun
authors: JM
authors: Lee
authors: Myung Hyun
authors: MH
authors: Sohn
authors: Kyu-Earn
authors: KE
authors: Kim
mesh_terms: D001249:Asthma / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D015415:Biomarkers / Q000378:metabolism; D001985:Bronchial Provocation Tests; D001991:Bronchitis / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D016085:Bronchoconstrictor Agents; D001993:Bronchodilator Agents; D016022:Case-Control Studies; D002648:Child; D003937:Diagnosis, Differential; D004804:Eosinophils / Q000378:metabolism; D045853:Exhalation; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D016210:Methacholine Chloride; D009569:Nitric Oxide / Q000378:metabolism*; D009991:Oscillometry; D011657:Pulmonary Eosinophilia / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013147:Spirometry; D013183:Sputum / Q000378:metabolism
chemical_list: D015415:Biomarkers; D016085:Bronchoconstrictor Agents; D001993:Bronchodilator Agents; D016210:Methacholine Chloride; D009569:Nitric Oxide