Gender/Age: Female under 10 years old
History: Both parents have asthma and hay fever; the patient has hay fever and eczema

• Cough
• Chest tightness
• Wheeze during sports and in cold weather; symptoms worse at night

Despite the typical asthma symptoms and family history, there was reluctance to make a formal asthma diagnosis. Spirometry is often recommended for children, but pediatric spirometry was not available at this practice.

Serial Peak Flow: Conducted and showed reversible airway obstruction in response to a short-acting bronchodilator, supporting the likelihood of asthma. Not all children can perform peak flow tests, but this patient was able to provide useful data.

Inhaled Corticosteroid (ICS): The positive FeNO result reassured the parents about the need for anti-inflammatory treatment, and the patient was started on an ICS.

• The FeNO test result helped the parents understand the inflammation present in their child’s airways, making them more comfortable with the diagnosis and treatment.
• Plans were made to repeat the FeNO test after treatment to confirm that the inflammation had been reduced, ensuring effective asthma control.