Reported symptoms differentiate diagnoses in children with exercise-induced respiratory problems: findings from the Swiss Paediatric Airway Cohort (SPAC).

Pedersen, Eva SL; de Jong, Carmen CM; Ardura-Garcia, Cristina; Mallet, Maria Christina; Barben, Juerg; Casaulta, Carmen; Hoyler, Karin; Jochmann, Anja; Moeller, Alexander; Mueller-Suter, Dominik; Regamey, Nicolas; Singer, Florian; Goutaki, Myrofora; Kuehni, Claudia E. (2021). Reported symptoms differentiate diagnoses in children with exercise-induced respiratory problems: findings from the Swiss Paediatric Airway Cohort (SPAC). Journal of allergy and clinical immunology. In practice, 9(2), 881-889.e3. Elsevier 10.1016/j.jaip.2020.09.012

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BACKGROUND

Exercise-induced breathing problems with similar clinical presentations can have different etiologies. This makes distinguishing common diagnoses such as asthma, extrathoracic and thoracic dysfunctional breathing (DB), insufficient fitness, and chronic cough difficult.

OBJECTIVE

We studied which parent-reported, exercise-induced symptoms can help distinguish diagnoses in children seen in respiratory outpatient clinics.

METHODS

This study was nested in the Swiss Paediatric Airway Cohort (SPAC), an observational study of children aged 0-17 years referred to pediatric respiratory outpatient clinics in Switzerland. We studied children aged 6-17 years and compared information on exercise-induced symptoms from parent-completed questionnaires between children with different diagnoses. We used multinomial regression to analyze whether parent-reported symptoms differed between diagnoses (asthma as base).

RESULTS

Among 1109 children, exercise-induced symptoms were reported for 732 (66%) (mean age 11 years, 318 of 732 [43%] female). Among the symptoms, dyspnea best distinguished thoracic DB (relative risk ratio [RRR] 5.4, 95%CI 1.3-22) from asthma. Among exercise triggers, swimming best distinguished thoracic DB (RRR 2.4, 95%CI 1.3-6.2) and asthma plus DB (RRR 1.8, 95%CI 0.9-3.4) from asthma only. Late onset of symptoms was less common for extrathoracic DB (RRR 0.1, 95%CI 0.03-0.5) and thoracic DB (RRR 0.4, 95%CI 0.1-1.2) compared with asthma. Localization of dyspnea (throat vs. chest) differed between extrathoracic DB (RRR 2.3, 95%CI 0.9-5.8) and asthma. Reported respiration phase (inspiration or expiration) did not help distinguish diagnoses.

CONCLUSION

Parent-reported symptoms help distinguish different diagnoses in children with exercise-induced symptoms. This highlights the importance of physicians obtaining detailed patient histories.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Paediatric Pneumology

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Pedersen, Eva Sophie Lunde; de Jong, Carmen Cornelia Maria; Ardura Garcia, Cristina; Mallet, Maria Christina; Singer, Florian; Goutaki, Myrofora and Kühni, Claudia

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

2213-2198

Publisher:

Elsevier

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

15 Oct 2020 20:29

Last Modified:

10 Feb 2021 01:32

Publisher DOI:

10.1016/j.jaip.2020.09.012

PubMed ID:

32961313

Uncontrolled Keywords:

Exercise-induced ILO adolescents asthma childhood dysfunctional breathing

BORIS DOI:

10.7892/boris.146861

URI:

https://boris.unibe.ch/id/eprint/146861

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