Bronchodilation test with inhaled salbutamol versus bronchial methacholine challenge to make an asthma diagnosis: do they provide the same information?

Publication date: Available online 18 September 2019Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Renaud Louis, Nicolas Bougard, Françoise Guissard, Virginie Paulus, Monique Henket, Florence SchleichAbstractBackgroundMethacholine bronchial challenge and bronchodilation to salbutamol are key tests in clinical practice to make asthma diagnosis.ObjectiveTo assess the concordance between the two tests and to see whether they actually identify the same population of asthmaticsMethodWe conducted a retrospective study using our asthma clinic database to see how methacholine bronchial challenge compared to bronchodilation to salbutamol in untreated patients with recurrent or chronic symptoms suspicious of asthma. We identified 194 untreated patients with baseline FEV1> 70% predicted who had both a bronchodilation test with salbutamol and a methacholine bronchial challenge 7-14 days apart. A positive bronchial challenge was a provocative concentration of methacholine causing a 20% fall in FEV1 ≤ 16mg/ml while a positive bronchodilation test was a reversibility to 400 μg inhaled salbutamol ≥ 12% from baseline and 200 ml.ResultsOverall, asthma diagnosis was confirmed in 91% of cases leaving 9% of subjects with double negative tests. Isolated positive methacholine challenge was found in 71% of subjects, double positive tests in 17%, while isolated significant bronchodilation to salbutamol was rare (3%). There was no correlation between P...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research

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Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Source Type: research
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Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Source Type: research
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Source: Journal of Allergy and Clinical Immunology - Category: Allergy & Immunology Authors: Source Type: research
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