Airway Hyperresponsiveness in Pediatric Recurrent Respiratory Illness: Diagnostic Approaches and Therapeutic Strategies
Keywords:
airway hyperresponsiveness, children, bronchial asthma, spirometry, methacholine challenge, FeNO, inhaled corticosteroidsAbstract
Background: Airway hyperresponsiveness (AHR) is a hallmark feature of obstructive airway disease in children and adolescents, yet it remains underdiagnosed in those presenting with recurrent respiratory illnesses. Objective: To evaluate the prevalence, severity, and clinical correlates of AHR in pediatric patients and to compare the diagnostic performance of multiple instrumental techniques alongside therapeutic responses. Methods: A combined retrospective and prospective study was conducted at the Pulmonology Department of the Fergana City Children’s Hospital over three years (2021–2024), enrolling 78 patients aged 5–17 years with recurrent respiratory illness and 78 healthy age- and sex-matched controls. Spirometry, methacholine challenge testing, fractional exhaled nitric oxide (FeNO), and impulse oscillometry were applied. Results: AHR was confirmed in 71.8% of the main group. Median PC20 was 2.4 mg/mL in bronchial asthma patients versus 22.5 mg/mL in controls (p < 0.001). FeNO levels were significantly elevated. Conclusion: Methacholine challenge combined with FeNO measurement provides optimal diagnostic sensitivity for AHR in children, and stepwise inhaled corticosteroid therapy remains the cornerstone of effective management.
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