Relation of airway responsiveness to methacholine to parent and child reporting of symptoms suggesting asthma: RESULTS Part 2

Symptoms reported by parents: Physician-diagnosed asthma was reported by parents for 26 children (14 male) or 9.0% of the study population (Tables 2,3). Of these, 19 had had asthma symptoms in the past 12 months, and 11 had had four or more episodes during that time.

The parents of 74 children (44 male) reported their child had experienced wheezing at some time up to age nine years, giving a cumulative prevalence of a history of wheezing (including those diagnosed as asthmatic) of 25.5%. Of these children, only 42 (57%, or 14.5% of the study sample) had had symptoms within the past 12 months, and the majority of these (28 of 42) were reported by their parents to have had fewer than four attacks in that period.

Recurrent cough was reported by parental questionnaire for 80 children (27.6%). Of these, 41 had physician-diagnosed asthma, wheezing or exercise induced wheezing, seven had breathlessness on exertion, while the remaining 32 children (11.0% of the sample) were reported to have had a dry cough without wheeze.

Symptoms reported by children: The majority of children whose parents reported they had had symptoms within the past 12 months confirmed this symptomatic status by their own report (Tables 2,3). Those with more remote histories with no recent symptoms frequently were not aware of early childhood wheezing reported by the parent.

Despite a totally negative questionnaire returned by the parent, one child reported asthma, describing chest tightness without wheeze, while 26 children (9.0%) reported having had wheezing and a further 21 (7.2%) a recurrent dry cough. Airway hyperresponsiveness: Of the 230 children consenting to methacholine challenge, one symptomatic child was given salbutamol only because FEV1/VC was less than 0.7. Of the 229 tested, PC20FEV1 was < 1 mg/mL in six, <2 mg/mL in 28, <4 mg/mL in 46 and <8 mg/mL in 78 (cumulative totals). Of the 28 children with PC20 <2 mg/mL, 10 had negative parental questionnaires, asdid37 of78 children (cumulative totals) with PC20 <8 mg/mL. Spend less money whenever you want to cialis professional and be sure your medications are costing less and less as you continue shopping with the pharmacy you chose to be your number one destination for efficient drugs required.

TABLE 2
Degree of methacholine responsiveness of 229 children tested, by diagnosis or symptoms reported by parental questionnaire or by child questionnaire

Methacholine PC20FEV1 (mg/mL)
<1 >1 <2 >2 <4 >4 <8 >8 <16 >16 Total
Parent questionnaire
Diagnosed asthma 2 6 3 2 1 7 21
Wheezing, not diagnosed ‘asthma’ 2 3 4 8 8 17 42
Total asthma and wheezing 4 9 7 10 9 24 63
Recurrent dyspnea 1 4 2 4 9 20 40
Total symptomatic in past year 5 13 9 14 18 44 103
Child questionnaire
Diagnosed asthma 2 4 3 2 1 4 16
Wheezing, not diagnosed ‘asthma’ 1 6 3 8 10 26 54
Total asthma and/or wheezing 3 10 6 10 11 30 70
Recurrent cough or dyspnea 1 3 4 5 6 16 35
Total symptomatic 4 13 10 15 17 46 105
Parent or child questionnaire
Asthma 2 6 3 3 2 8 24
Asthma or wheeze 5 13 10 15 17 39 99
Any symptoms* 6 16 14 19 27 61 143
No symptoms 0 6 4 13 20 43 86
All subjects (noncumulative) 6 22 18 32 47 104 229
All subjects (cumulative up to 16 mg/mL) 6 28 46 78 125 104 229

*Asthma, wheezing, dyspnea or cough at any time. PC20FEV1 Provocation concentration of methacholine causing a 20% fall in forced expired volume in 1 s. Data are noncumulative. Data from this table were used to construct the receiver operating characteristic diagrams

TABLE 3
Degree of methacholine responsiveness of 229 children tested, by diagnosis or symptoms reported within the past 12 months by parental questionnaire or by child questionnaire

Methacholine PC20FEV1 (mg/mL)
<1 >1 <2 >2 <4 >4 <8 >8 <16 >16 Total
Parent questionnaire positive
Diagnosed asthmaWheezing, not diagnosed ‘asthma’ 21 31 31 14 04 511 1422
Total asthma and wheezing 3 4 4 5 4 16 36
Recurrent dyspnea 0 1 0 1 0 2 4
Total symptomatic in past year 3 5 4 6 4 18 40
Child questionnaire
Diagnosed asthma 2 3 3 2 4 4 15
Wheezing, not diagnosed ‘asthma’ 1 3 3 6 18 18 38
Total asthma and wheezing 3 6 6 8 22 22 53
Recurrent cough or dyspnea 0 0 0 0 0 9
Total symptomatic in past year 3 6 6 8 8 22 53
Parent or child questionnaire
Asthma 2 3 2 1 7 18 24
Asthma or wheeze 4 6 9 11 28 65 99
Any symptoms in past year* 4 6 10 11 29 67 143
No symptoms in past year 2 16 22 36 75 142 86
All subjects (noncumulative) 6 22 32 47 104 229 229
All subjects (cumulative up to 16 mg/mL) 6 28 46 125 104 229 229

*Asthma, wheezing, dyspnea. PC20FEV1 Provocation concentration of methacholine causing a 20% fall in forced expired volume in 1 s. Data are noncumulative. Data from this table were used to construct the receiver operating characteristic diagrams


Category: Airway responsiveness

Tags: Airway responsiveness, Asthma, Methacholine, Symptom reporting

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