RT Journal Article
SR Electronic
T1 Choice of nasal Nitric Oxide technique as first line test for primary ciliary dyskinesia
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP erj00326-2010
DO 10.1183/09031936.00032610
A1 J.K. Marthin
A1 K.G. Nielsen
YR 2010
UL http://erj.ersjournals.com/content/early/2010/06/04/09031936.00032610.abstract
AB Nasal nitric oxide (nNO) has a well-known potential as indirect discriminative marker between patients with primary ciliary dyskinesia (PCD) and healthy subjects, but real-life experience and usefulness in young children is sparsely reported. Three nNO sampling methods were examined and compared as first-line tests for PCD.Healthy subjects, confirmed PCDs, consecutive referrals with PCD-like symptoms and patients with cystic fibrosis (CF) had nNO sampled during breath hold (BH-nNO), oral exhalation against resistance (OE-R-nNO), and tidal breathing (TB-nNO) aiming to expand age range into infancy.282 subjects, 117 consecutive referrals, 59 PCDs, 49 CF patients and 57 healthy were included. All methods separated significantly between PCD and non-PCD including CF with reliability in ranking order BH-nNO > OE-R-nNO > TB-nNO. Acceptability in children ranked in reverse order. A problematic high fraction (39%) of false positive TB-nNO was found in young children. An unexpected large fraction (6.8%) of PCDs had nNO values above cut-off.Nasal NO is a helpful first-line tool in real-life PCD work-up in all age groups if sampling method is chosen according to age. nNO can be misleading in a few patients with true PCD. Further studies are strongly needed in young children.