Análisis comparativo de la fracción exhalada de óxido nítrico en niños y en adolescentes con rinitis alérgica y no alérgica

Ricardo Saranz, Alejandro Lozano, Natalia Andrea Lozano, Graciela Alegre, Laura Verónica Sasia, Eugenia Cóncari, Paula Robredo, Marina Ponzio, Álvaro Cruz

Resumen


Antecedentes: Existe inflamación bronquial subclínica en pacientes con rinitis alérgica. Son menos las evidencias de inflamación de la vía aérea inferior en rinitis no alérgica.

Objetivo: Investigar inflamación de la vía aérea inferior por la fracción exhalada de óxido nítrico (FeNO) en pacientes con rinitis alérgica y rinitis no alérgica sin asma y su asociación con función pulmonar, gravedad de la rinitis y biomarcadores de atopia.

Métodos: Estudio transversal de pacientes entre seis y 18 años, con rinitis alérgica o rinitis no alérgica sin asma. Se realizó espirometría, IgE sérica, recuento de eosinófilos hemáticos y FeNO. Se clasificó la rinitis según guía ARIA.

Resultados: Se incluyeron 40 pacientes, 28 con rinitis alérgica y 12 con rinitis no alérgica. Los pacientes con rinitis alérgica tuvieron niveles de FeNO más elevados (mediana 36.5 ppb, rango 5-114) que aquellos con rinitis no alérgica (mediana 7 ppb, rango 5-24) (p = 0.0011). La FeNO elevada se asoció con anormalidad espirométrica (RM = 7.14 [IC 95 % = 1.04-49.04], p = 0.049). En la rinitis alérgica, existió correlación entre FeNO y eosinófilos en sangre (r = 0.41, p = 0-33).

Conclusiones: Los niños y adolescentes con rinitis alérgica tuvieron FeNO más elevada que los pacientes con rinitis no alérgica, que se correlacionó con eosinofilia hemática y función pulmonar alterada.


Palabras clave


Rinitis; Inflamación; Espirometría; Fracción exhalada de óxido nítrico

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DOI: http://dx.doi.org/10.29262/ram.v66i3.583

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