Sarvinder Singh1. 1. Consultant (Med & Resp Med), Army Hospital (R&R), Delhi Cantt 110010, India.
Abstract
BACKGROUND: Bronchial hyper-responsiveness (BHR) is the hallmark of bronchial asthma, characterized by clinical features of cough, wheeze, breathlessness and chest tightness which are confirmed by spirometry showing obstructive pattern and reversibility to bronchodilators. In individuals having features of bronchial asthma but normal spirometry, demonstration of BHR with bronchial challenge test (direct or indirect) confirms/ rules out the diagnosis. The aim of this study was to assess BHR in patients (methacholine challenge) with a history suggestive of bronchial asthma but normal spirometry and its role in diagnosis of bronchial asthma. METHODS: This study was conducted at tertiary care respiratory center. Patients having clinical features of bronchial asthma but spirometry not confirming obstructive disorder and or reversibility were included in the study. After written consent, methacholine challenge test with methacholine chloride and exercise spirometry was done in all patients as per the American Thoracic Society protocol. RESULTS: A total of 50 (n) patients were included in the study. Among them, 42 patients had clinical features suggestive of bronchial asthma but having normal spirometry and eight patients were diagnosed as they had bronchial asthma in the past but asymptomatic and off drugs were included in the study. At PC20 4mg/ml 32 (64%) patients had a positive test, 28(66%) symptomatic patients and four (50%) asymptomatic asthmatics. There were no significant side effects with methacholine test. CONCLUSION: Airway hyper-responsiveness is an important aspect of bronchial asthma and its demonstration with bronchial challenge (direct and indirect) test is an important diagnostic tool. Methacholine challenge test is a safe procedure to perform under supervision.
BACKGROUND: Bronchial hyper-responsiveness (BHR) is the hallmark of bronchial asthma, characterized by clinical features of cough, wheeze, breathlessness and chest tightness which are confirmed by spirometry showing obstructive pattern and reversibility to bronchodilators. In individuals having features of bronchial asthma but normal spirometry, demonstration of BHR with bronchial challenge test (direct or indirect) confirms/ rules out the diagnosis. The aim of this study was to assess BHR in patients (methacholine challenge) with a history suggestive of bronchial asthma but normal spirometry and its role in diagnosis of bronchial asthma. METHODS: This study was conducted at tertiary care respiratory center. Patients having clinical features of bronchial asthma but spirometry not confirming obstructive disorder and or reversibility were included in the study. After written consent, methacholine challenge test with methacholine chloride and exercise spirometry was done in all patients as per the American Thoracic Society protocol. RESULTS: A total of 50 (n) patients were included in the study. Among them, 42 patients had clinical features suggestive of bronchial asthma but having normal spirometry and eight patients were diagnosed as they had bronchial asthma in the past but asymptomatic and off drugs were included in the study. At PC20 4mg/ml 32 (64%) patients had a positive test, 28(66%) symptomatic patients and four (50%) asymptomatic asthmatics. There were no significant side effects with methacholine test. CONCLUSION: Airway hyper-responsiveness is an important aspect of bronchial asthma and its demonstration with bronchial challenge (direct and indirect) test is an important diagnostic tool. Methacholine challenge test is a safe procedure to perform under supervision.
Authors: R O Crapo; R Casaburi; A L Coates; P L Enright; J L Hankinson; C G Irvin; N R MacIntyre; R T McKay; J S Wanger; S D Anderson; D W Cockcroft; J E Fish; P J Sterk Journal: Am J Respir Crit Care Med Date: 2000-01 Impact factor: 21.405
Authors: Nicole Beydon; Stephanie D Davis; Enrico Lombardi; Julian L Allen; Hubertus G M Arets; Paul Aurora; Hans Bisgaard; G Michael Davis; Francine M Ducharme; Howard Eigen; Monika Gappa; Claude Gaultier; Per M Gustafsson; Graham L Hall; Zoltán Hantos; Michael J R Healy; Marcus H Jones; Bent Klug; Karin C Lødrup Carlsen; Sheila A McKenzie; Francçois Marchal; Oscar H Mayer; Peter J F M Merkus; Mohy G Morris; Ellie Oostveen; J Jane Pillow; Paul C Seddon; Michael Silverman; Peter D Sly; Janet Stocks; Robert S Tepper; Daphna Vilozni; Nicola M Wilson Journal: Am J Respir Crit Care Med Date: 2007-06-15 Impact factor: 21.405
Authors: Allan L Coates; Jack Wanger; Donald W Cockcroft; Bruce H Culver; Zuzana Diamant; Gail Gauvreau; Graham L Hall; Teal S Hallstrand; Ildiko Horvath; Frans H C de Jongh; Guy Joos; David A Kaminsky; Beth L Laube; Joerg D Leuppi; Peter J Sterk Journal: Eur Respir J Date: 2017-05-01 Impact factor: 16.671