The correlation of adenosine challenge test results with subsequent clinical course among young children with suspected asthma: a retrospective cohort study

Pediatr Pulmonol. 2019 Jul;54(7):1087-1092. doi: 10.1002/ppul.24337. Epub 2019 Apr 17.

Abstract

Aim: Our aim was to evaluate the correlation of Adenosine monophosphate challenge test (AMP-PCW) results with the patients' subsequent clinical course.

Methods: We performed a 6-year retrospective cohort study of young children with suspected asthma who underwent AMP-PCW test.

Results: Fifty four children were included in the study (median age, 50.5 months; range, 26-90). AMP-PCW was positive in 35 (65%) children. During the 3-year follow-up period, among 22 of 35 patients in the positive AMP-PCW group and among 17 of 19 in the negative AMP-PCW group-prophylactic therapy was not changed. Prophylactic therapy was initiated or its dose was escalated in 12 of 13 (92.3%) of the children with a positive AMP-PCW test compared to none of the children with a negative challenge test (P < 0.001). Prophylactic therapy was discontinued in only one (7.6%) of the children with a positive test as compared to two (100%) of the children with a negative test (P < 0.001). There were significantly fewer severe asthma exacerbations during a 3-year follow-up period after the challenge test as compared to the preceding 3-year period both in children with a positive (from 34 to 9 total events, P = 0.01) or a negative challenge test (from 16 to 0 events P = 0.01). The severity of airway hyper responsiveness was found to associate with the number of severe asthma exacerbations (P = 0.04) and with a diagnosis of asthma during the following 3 years (P = 0.02).

Conclusions: AMP-PCW test results correlates with the subsequent clinical course of young children with suspected asthma performing the test.

Keywords: adenosine; asthma; challenge test; hyper-responsiveness; wheezing.

MeSH terms

  • Adenosine Monophosphate / administration & dosage*
  • Asthma / diagnosis*
  • Bronchial Provocation Tests / methods*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Retrospective Studies

Substances

  • Adenosine Monophosphate