Exhaled nitric oxide in the diagnosis of childhood asthma
Posted Jan 18 2010 12:35am
Although asthma is the most common chronic disease of childhood, it remains a clinical diagnosis. Common symptoms include recurrent wheezing, cough, difficulty in breathing, and chest tightness, but no agreed "gold standard" definition exists. Improvements in symptoms and lung function seen after adequate treatment often provide retrospective confirmation of the diagnosis.
Accurate diagnosis of asthma in children may be difficult but is vital for two reasons. Firstly, a correct diagnosis is essential for the institution of guideline based treatment, which may involve specialist referral; this is needed to avoid the morbidity and rarely mortality associated with poorly controlled disease. Secondly, the exclusion of asthma prevents potential harm from inappropriate anti-asthma treatment and may highlight other crucial diagnoses such as cystic fibrosis.
Asthma is a heterogeneous disease, and data from large population based studies have informed the concept of different patterns or "phenotypes" in children who wheeze.