Elsevier

The Journal of Pediatrics

Volume 127, Issue 3, September 1995, Pages 438-440
The Journal of Pediatrics

Comparison of adenosine 5'-monophosphate and methacholine for the differentiation of asthma from chronic airway diseases with the use of the auscultative method in very young children,☆☆,

https://doi.org/10.1016/S0022-3476(95)70079-XGet rights and content

Abstract

Methacholine and adenosine 5'-monophosphate bronchial challenges were performed in 54 young children—39 with asthma and 15 with other chronic airway diseases (CADs), with the use of the auscultative method. Children with asthma were sensitive to both methacholine and adenosine; children with CAD responded only to methacholine. We conclude that bronchial challenge with adenosine can help differentiate asthma from CAD in young children. (J PEDIATR 1995;127:438-40)

Section snippets

METHODS

Thirty-nine children (mean age ± SD, 4.3 ± 1.4 years) who met the American Thoracic Society's diagnostic criteria for asthma9 and 15 children (mean age, 4.4 ± 1.5 years) with other chronic airway diseases participated in the study. The latter group included 5 children with recurrent upper respiratory tract infection and chronic cough unresponsive to antiasthma treatment, 5 with recurrent pneumonia, 3 with bronchiolitis obliterans, and 2 with cystic fibrosis. All patients avoided bronchodilator

RESULTS

There was no significant difference (p = 0.75) between the mean age of the children with asthma and that of the CAD group. The logarithmic mean PCW to methacholine in subjects with asthma (0.36 mg/ml, range 0.12 to 1.08 mg/ml) was not significantly different (p = 0.82) from that in the CAD group (0.39 mg/ml, range 0.09 to 1.66 mg/ml). The logarithmic mean PCW to adenosine in children with asthma (8.3 mg/ml, range 1.8 to 37.8 mg/ml) was significantly (p < 0.00001) smaller than that in the CAD

DISCUSSION

Methacholine has been widely used for the detection and quantitation of bronchial hyperreactivity in bronchial asthma. All patients with active disease react to less than 8 mg/ml of histamine or methacholine.1 In the present study, all children in both groups reacted similarly to methacholine with a PCW less than 8 mg/ml. Similar results were found in our previous study with older children and young adults with the use of a conventional challenge technique.8

During the adenosine challenge, most

References (9)

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From the Institute of Pulmonology, Hadassah University Hospital, Jerusalem, Israel

☆☆

Reprint requests: A. Avital, MD, Institute of Pulmonology, Hadassah University Hospital, PO Box 12000, Jerusalem, Israel.

0022-3476/95/$5.00 + 0 9/22/66052

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