Important Safety Information | NIOX VERO® User Manual (PDF)
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Case Study:
Shortness of Breath
19-Year-Old College Athlete With a 6-Month History of Shortness of Breath Under Asthma Management*
*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 identify a nonasthma-related condition with poor response to an inhaled corticosteroid/long-acting beta agonist (ICS/LABA).
Had FeNO been measured at the onset of this patient’s dyspneic symptoms, the symptoms may not have been attributed to a pulmonary inflammatory process. He possibly could have then avoided unnecessary asthma medication trials, chest x-rays, and repeat pulmonary function tests.
Patient Background
- Reported shallow breathing and sensation of not having a full breath of air on a daily basis
- No nocturnal symptoms
- Became acutely short of breath, had perioral cyanosis, and lost consciousness while running on the treadmill for an endurance test 1 week prior to evaluation
- Previous pulmonary function tests were reportedly normal
- Patient previously treated with albuterol for exercise-induced bronchospasm
- History of allergic rhinitis, well controlled with antihistamines
- Maintained on ICS/LABA to treat continued symptoms
NIOX-Guided Assessment
- Fractional exhaled nitric oxide (FeNO) level <20 ppb suggested an absence of airway inflammation
- Repeat pulmonary function testing normal with minimal bronchodilation after albuterol
- Methacholine challenge negative
- Possible presence of a condition mimicking asthma, such as vocal cord dysfunction (VCD)
Treatment
- Stopped treatment for asthma
- Scheduled follow-up visits at 2 weeks, 6 weeks, and 3 months
- Prescribed biofeedback training to control VCD and hyperventilation
Follow Up
- The patient’s episodes resolved, and FeNO remained <20 ppb at each follow-up visit despite the withdrawal of ICS/LABA.
