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Case Study:

Chronic Cough

38-Year-Old Female With History of Coughing*

*The case study presented is for educational purposes only and does not represent a real patient case. Similar results cannot be guaranteed and should not be considered typical.

Role of FeNO

FeNO testing helped guide an appropriate workup and diagnosis of this patient and helped avoid an expensive immunodeficiency workup that would not have been useful.

Patient Background

  • Referred for possible immunodeficiency
  • Patient presented with a worsening shortness of breath, chest tightness, and coughing, especially in the previous 2 weeks
  • Frequent bronchitis, sinusitis, and strep throat over the previous 6 months
  • Previous pulmonary function tests were reportedly normal
  • No previous known history of allergy or asthma
  • No past or current medications for her condition

NIOX-Guided Assessment

  • Her fractional exhaled nitric oxide (FeNO) measurement was 52 ppb suggesting significant airway inflammation
  • Chest x-ray was normal, pulmonary function tests were 68% of predicted
  • Allergy test results were positive for cats, dogs, trees, grasses, and weeds

Treatment

  • Treated for asthma aggressively with oral steroids for 5 days
  • Started a short-acting bronchodialator as needed, and combination inhaled corticosteroid and long-acting beta agonist

Follow Up

  • Continuously improving, patient had a resolution of asthma symptoms and has been well controlled since starting appropriate treatment
  • Repeat FeNO was 16 ppb
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