Chest
Clinical InvestigationsDistilled Water Challenges in Asthmatic Children: Comparison of Different Protocols
Section snippets
Subjects
Fifteen asthmatic patients, eight girls and seven boys, aged 11.5 ± 2.9 years (mean ± SD; range: 7.75 to 17 years) with positive results from MCh entered the study. All patients had asthma previously diagnosed by a physician and gave a history of episodic dyspnea, wheezing, and coughing. Asthma was precipitated by exercise in six patients, by exposure to known allergens in four patients, and by cold, foggy weather in three patients. Standardized skin prick testing, radioallergosorbent tests
Results
Twelve patients completed the six different challenges, and none developed symptoms or signs of respiratory distress. The challenges were well tolerated except for a mild cough at the beginning of UNDW inhalations. Three patients had to be excluded because of inability to hyperventilate as required for CACh (two patients) or for lack of compliance (one patient).
Baseline results from PFTs and maximum responses of PF to challenge tests are summarized in Table 1. There were no significant
Discussion
In our study, MCh was used as the criterion standard for measuring nonspecific bronchial hyperresponsiveness in asthmatic children. Against this standard, the sensitivity of cUNDW was 67 percent and that of iUNDW was 75 percent. This is in broad agreement with other authors who reported sensitivities of between 52 and 68 percent for iUNDW challenge.4, 5, 9 In contrast, Anderson et al3 found an iUNDW sensitivity of 100 percent. We have no ready explanation for the discrepancy between the latter
ACKNOWLEDGMENT
We thank Brigitte Pomianek and Marianne Koller for their technical assistance, and H. Herkner, Ph.D., for the PRIST and RAST studies.
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2001, Annals of Allergy, Asthma and ImmunologyInhalation bronchoprovocation in children
1998, Immunology and Allergy Clinics of North AmericaIndirect bronchial hyperresponsiveness in asthma: Mechanisms, pharmacology and implications for clinical research
2000, European Respiratory JournalOsmotic regulation of airway reactivity by epithelium
1999, Journal of Pharmacology and Experimental Therapeutics
Manuscript received October 31; revision accepted January 24.