Abstract
A boy of 8-year-old with severe atopic asthma was hospitalized for treatment and attending special-needs school. Asthmatic symptoms were relieved soon after hospitalization. So, poor compliance and chronic exposure to indoor allergens were suspected as the cause of intractable asthma.
In order to investigate the deleterious effect of home environment on lung function and airway inflammation, we were compared with peak expiratory flow (PEF) and exhaled nitric oxide (eNO) values on Friday and Monday, before and after spending weekend at patient home.
eNO values on Monday increased significantly compared to those on previous Friday, and decreased significantly on next Friday compared to eNO on previous Monday. (22.2±5.7 ppb, 31.9±6.5, 19.5±7.3, respectively. p<0.01) There was no significant change in PEF. Trial test for evaluating correlation between ICS reduction and eNO measures revealed that half reduction of ICS for 2 days showed no influence on eNO values. And, we confirmed the high level of indoor house dust mite and mold allergens in bedroom by visiting patient home.
Considering above, the increase in eNO values after spending at patient home for 2 days suggests that exacerbation of airway inflammation might be induced by indoor allergens. Exhaled nitric oxide measurement is useful to evaluate the deleterious effect of home environment on airway inflammation in an intractable asthmatic child.
