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Pale nasal mucosa affects airflow limitations in upper and lower airways in asthmatic children
Chikako Motomura1, Hiroshi Odajima1, Atsunobu Yamada2
1Department of Pediatrics, Fukuoka National Hospital, Fukuoka 811-1394, Japan.
Insights
A pale nasal mucosa in asthmatic children indicates more severe nasal eosinophil infiltration and reduced airflow in both upper and lower airways. This finding suggests a pale nasal appearance may predict airway limitations in pediatric asthma.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Otolaryngology
Background:
- Severe asthma is often associated with more severe rhinitis.
- Pale nasal mucosa is a characteristic clinical sign in individuals with severe allergic rhinitis.
Purpose of the Study:
- To determine if a pale nasal mucosa correlates with airflow limitations in the upper and lower airways of children with asthma.
Main Methods:
- Evaluated 54 asthmatic children (median age 10 years) using rhinomanometry, nasal scraping, and spirometry.
- Nasal mucosa appearance was assessed by an otolaryngologist.
- Patients received inhaled or intranasal corticosteroid treatments.
Main Results:
- Children with pale nasal mucosa (n=23) showed significantly reduced nasal airflow and increased nasal eosinophils compared to those with normal/pinkish mucosa (n=31).
- Pulmonary function parameters, including forced vital capacity (FVC), forced expiratory volume in 1 second, and peak expiratory flow, were significantly lower in the pale mucosa group.
- No significant difference in peripheral airway function (FEF25-75%) was noted between the groups.
Conclusions:
- Pale nasal mucosa in asthmatic children may predict nasal eosinophil infiltration and central airway obstruction.
- Clinicians should consider potential upper and lower airway airflow limitations when observing pale nasal mucosa in pediatric asthma patients.
Background:
Severe asthmatics are thought to have severer rhinitis than mild asthmatics. A pale nasal mucosa is a typical clinical finding in subjects with severe allergic rhinitis.
Objective:
The aim of this study was to investigate whether a pale nasal mucosa affects airflow limitations in the upper and lower airways in asthmatic children.
Methods:
Rhinomanometry, nasal scraping, and spirometry were performed in 54 asthmatic children (median age, 10 years). The nasal mucosa was evaluated by an otolaryngologist. Thirty-seven patients were treated with inhaled corticosteroids, and 11 patients were treated with intranasal corticosteroids.
Results:
Subjects with a pale nasal mucosa (n = 23) exhibited a lower nasal airflow (p < 0.05) and a larger number of nasal eosinophils (p < 0.05) in the upper airway as well as lower pulmonary functional parameters (p < 0.05 for all comparisons), i.e., the forced vital capacity (FVC), the forced expiratory volume in 1 second, and the peak expiratory flow, compared with the subjects who exhibited a normal or pinkish mucosa (n = 31). No significant difference in the forced expiratory flow between 25%-75% of the FVC, regarded as indicating the peripheral airway, was observed between the 2 groups.
Conclusion:
A pale nasal mucosa may be a predictor of eosinophil infiltration of the nasal mucosa and central airway limitations in asthmatic children. When allergists observe a pale nasal mucosa in asthmatic children, they should consider the possibility of airflow limitations in not only the upper airway, but also the lower airway.
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