Objective: Exercise-induced bronchoconstriction (EIB) is characterized by transient airway narrowing that occurs during or after physical activity. While it is commonly observed in individuals with asthma, it can also be seen in otherwise healthy children and adolescents. Exercise bronchial provocation tests are among the primary diagnostic tools used to assess EIB. This study aimed to investigate the relationship between the frequency of EIB and the diagnosis of asthma in pediatric patients who underwent exercise bronchial provocation testing.
Materials and Methods: Pediatric patients who underwent exercise bronchial provocation testing at the Pediatric Allergy and Immunology Clinic of Ankara Bilkent City Hospital between October 2023 and October 2024 were retrospectively evaluated. Demographic data, clinical symptoms, spirometric measurements, allergen sensitization status, and final diagnoses were obtained from medical records. A decrease in FEV1 of ≥10% from baseline was considered diagnostic for EIB.
Results: Among the 79 patients included in the study, 59.6% were female, with a median age of 14.5 years (IQR: 12-16). A positive exercise bronchial provocation test was observed in 54 patients (68.4%). Of these, 44 were diagnosed with EIB associated with asthma (EIBa), and 10 were diagnosed with exercise-induced bronchoconstriction without asthma (EIBwa). Despite a negative exercise provocation test, clinical evaluation revealed symptom patterns consistent with asthma in 7 patients, leading to a confirmed diagnosis. The positive predictive value for asthma diagnosis was 81.5%, and the negative predictive value was 72%. Allergic rhinitis was identified in 21 patients, 18 of whom had EIB, and aeroallergen sensitization was present in 37.0% of those with EIB.
Conclusion: Exercise bronchial provocation testing is a useful tool for evaluating exercise-induced respiratory symptoms, and its diagnostic value increases when correlated with clinical findings and allergologic assessment, particularly in the context of suspected asthma. Further studies are needed to clarify its role in pediatric practice.