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19-Year-Old College Athlete With a 6-Month History of Shortness of Breath Under Asthma Management*

Role of FeNO

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. She possibly could have then avoided unnecessary asthma medication trials, chest x-rays, and repeat pulmonary function tests.

Patient Background

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
  • Chest x-ray was clear, multiple doses of albuterol via nebulizer resulted in tachycardia
  • Patient previously treated with albuterol for exercise-induced bronchospasm
  • History of allergic rhinitis, well controlled with antihistamines
  • Past pulmonary function test results have been normal, with 9% bronchodilation after albuterol
  • Normal chest x-ray
  • Maintained on ICS/LABA to treat continued symptoms
NIOX-Guided Assessment

NIOX-Guided Assessment

Treatment

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

The patient’s episodes resolved, and her FeNO remained <20 ppb at each follow-up visit despite the withdrawal of ICS/LABA.

*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.