NDLI: Mannitol challenge does not confirm bronchial hyperreactivity in some histamine-responsive asthmatic children.

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Mannitol challenge does not confirm bronchial hyperreactivity in some histamine-responsive asthmatic children.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Swiebocka, Ewa M. Siergiejko, Grzegorz Siergiejko, Zenon
Description	Country affiliation: Poland Author Affiliation: Swiebocka EM ( Pediatrics, Gastroenterology and Allergology Department, University Children Hospital, Medical University of Bialystok, Bialystok, Poland.)
Abstract	OBJECTIVE: The aim of this study was to compare the usefulness of mannitol provocation test to that of classical histamine challenge in children with PC(20)FEV(1) histamine lower than 4 mg/ml. METHODS: Twenty-two adolescent patients (mean age of 15.4 ± 4.1 years) with established asthma (PC(20)FEV(1) histamine below 4 mg/ml) were included in this study. Bronchial challenge with mannitol was performed 1-2 days after the test with histamine. RESULTS: The fraction of positive results of mannitol test was markedly lower when compared with the histamine challenge (72.7% vs. 100%, p = .015). The test was discontinued in one case due to severe coughing after inhalation of 315 mg of mannitol. Coughing during inhalation of dry mannitol powder occurred in most patients, although drinking water after subsequent doses alleviated this symptom in nearly all of them. Of note, triboelectrification of the inhaler and capsules was observed during the administration of consecutive mannitol doses, markedly hindering the delivery of this provoking agent. The relative decrease in FEV(1) resulting from bronchial provocation was significantly lower following mannitol delivery when compared with the histamine test (70.3% vs. 81.6% of resting value, p < .001). Significant correlation was not observed between the values of PC(20)FEV(1) histamine and PD(15)FEV(1) mannitol levels. CONCLUSIONS: Bronchial challenge with mannitol can be used as a screening test in everyday practice, but one cannot exclude bronchial hyperresponsiveness based on its negative results. Moreover, its usefulness is limited by the influence of static on the delivery of sequential mannitol doses and coughing which can be often associated with mannitol inhalation.
File Format	HTM / HTML
ISSN	02770903
Issue Number	8
Volume Number	49
e-ISSN	15324303
Journal	Journal of Asthma
Language	English
Publisher	Taylor & Francis
Publisher Date	2012-10-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pulmonology Asthma Diagnosis Bronchial Provocation Tests Methods Mannitol Administration, Inhalation Adolescent Physiopathology Female Forced Expiratory Volume Drug Effects Histamine Administration & Dosage Humans Male Statistics, Nonparametric Young Adult Comparative Study Journal Article
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine Immunology and Allergy Pediatrics, Perinatology and Child Health

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