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Can early asthma be confirmed by laboratory tests?
T Metso1, K Kilpiö, F Björkstén
1Department of Allergic Diseases, Helsinki University Central Hospital, Finland.
Allergy
|April 1, 1996
Summary
Diagnosing asthma symptoms like cough and wheezing can be challenging. Combining lung function tests with eosinophil activation markers significantly improves diagnostic sensitivity, especially with improved sputum analysis.
Area of Science:
- Pulmonology
- Allergy and Immunology
- Diagnostic Medicine
Background:
- Asthma diagnosis in patients with recent onset symptoms (<1 year) like cough, sputum, and wheezing presents diagnostic challenges.
- Standard diagnostic tests, including histamine challenge, show limited sensitivity in early-stage asthma detection.
Purpose of the Study:
- To evaluate the diagnostic performance of individual and combined laboratory tests for asthma in patients with suggestive symptoms.
- To determine if combining lung function tests with markers of eosinophil activation enhances diagnostic accuracy.
Main Methods:
- Assessed the sensitivity of various laboratory tests in 23 patients presenting with asthma-like symptoms.
- Evaluated individual tests like histamine challenge, peak expiratory flow, sputum eosinophil cationic protein (ECP), and serum ECP.
- Analyzed the cumulative sensitivity achieved by combining different tests.
Main Results:
- Histamine challenge alone demonstrated a sensitivity of 48%.
- Adding peak expiratory flow increased sensitivity to 65%.
- Further addition of sputum ECP and serum ECP elevated sensitivity to 74% and 78%, respectively.
Conclusions:
- A combination of lung function tests and eosinophil activation markers provides fair to good sensitivity for diagnosing early-stage asthma.
- Further improvements in sputum analysis may enhance diagnostic sensitivity for asthma.