AI Article Synopsis
- Cough-variant asthma (CVA) and cough-predominant asthma (CPA) are common causes of persistent cough in Japan. This study analyzed FeNO levels in 105 patients to differentiate between asthmatic and non-asthmatic coughs.
- Higher FeNO levels were found in CPA and CVA patients compared to non-asthmatic coughs, indicating that FeNO can be useful for diagnosis, though lower levels may not be as reliable.
- The effectiveness of FeNO measurement in diagnosing asthma-related coughs varies based on atopic status, highlighting the importance of considering this factor in evaluations.
Article Abstract
Background: Cough-variant asthma (CVA) and cough-predominant asthma (CPA) are the major causes of persistent cough in Japan. The utility of fractional exhaled nitric oxide (FeNO) measurement in the differential diagnosis of persistent cough has been reported, but the influence of atopic status, which is associated with higher FeNO levels, on the diagnostic utility of FeNO has been unknown.
Methods: We retrospectively analyzed 105 non-smoking patients with prolonged and chronic cough that were not treated with corticosteroids and anti-leukotrienes.
Results: CPA was diagnosed in 37 patients, CVA in 40, and non-asthmatic cough (NAC) in 28. FeNO levels were significantly higher in the CPA [35.8 (7.0-317.9) ppb] and CVA [24.9 (3.1-156.0) ppb] groups than in the NAC group [18.2 (6.9-49.0) ppb] (p < 0.01 by Kruskal-Wallis test). The optimal cut-off for distinguishing asthmatic cough (AC; CPA and CVA) from NAC was 29.2 ppb [area under the curve (AUC) 0.74, p < 0.01]. Ninety-one percent of subjects with FeNO levels ≥29.2 ppb had AC. Meanwhile, 40% of AC patients had FeNO levels <29.2 ppb. Stratified cut-off levels were 31.1 ppb (AUC 0.83) in atopic subjects vs. 19.9 ppb (AUC 0.65) in non-atopic subjects (p = 0.03 for AUC).
Conclusions: Although high FeNO levels suggested the existence of AC, lower FeNO levels had limited diagnostic significance. Atopic status affects the utility of FeNO levels in the differential diagnosis of prolonged and chronic cough.
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| http://dx.doi.org/10.1016/j.alit.2016.08.015 | DOI Listing |
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