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Different cutoff values of methacholine bronchial provocation test depending on age in children with asthma

Eun Lee1, Young-Ho Kim2, Seungbong Han3

  • 1Department of Pediatrics, Chonnam National University Hospital, Gwangju, Korea.

World Journal of Pediatrics : WJP
|March 10, 2017
PubMed

Insights

Establishing age-dependent cutoff values for bronchial hyperresponsiveness (BHR) using the methacholine challenge test (MCT) aids in diagnosing asthma in children. This study determined specific methacholine PC20 thresholds for children aged 6-15 years.

Area of Science:

  • Pediatric Allergy and Immunology
  • Respiratory Medicine
  • Diagnostic Medicine

Background:

  • Bronchial hyperresponsiveness (BHR) is a key feature of asthma.
  • Current diagnostic criteria for pediatric asthma lack age-specific BHR cutoffs.
  • This study addresses the need for age-dependent methacholine challenge test (MCT) values.

Purpose of the Study:

  • To establish age-specific cutoff values for methacholine PC20 in diagnosing asthma in children.
  • To investigate the relationship between age and BHR thresholds in pediatric asthma diagnosis.
  • To provide practical diagnostic guidelines for pediatric asthma.

Main Methods:

  • A cohort of 2383 children (6-15 years) including suspected asthmatics and healthy controls.
  • Methacholine challenge tests (MCTs) performed using the five-breath method.
  • Receiver-operator characteristic (ROC) curve analysis to determine optimal PC20 cutoff values for asthma diagnosis.

Main Results:

  • Methacholine PC20 cutoff values demonstrated a clear increasing trend with age.
  • Specific cutoff values ranged from 5.8 mg/mL at age 6 to 24.6 mg/mL at age 15.
  • These age-dependent values offer improved sensitivity and specificity for asthma diagnosis.

Conclusions:

  • Age-specific cutoff values for methacholine PC20 are crucial for accurate asthma diagnosis in children.
  • Implementing these age-dependent thresholds can refine the diagnostic process for pediatric asthma.
  • This approach offers a practical modification for diagnosing asthma in symptomatic children and adolescents.
Abstract

Keywords:
asthmabronchial hyperresponsivenesscutoff valuereceiver-operator characteristics

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