Leila is an energetic 6 year old girl who recently started struggling with a persistent cough, chest tightness, and wheezing, especially during sports and in cold weather. Her symptoms often became worse at night, making it hard for her to get a good night's sleep. With a family history of asthma and hay fever on both sides, her parents grew concerned that Leila might also have asthma. After various tests, FeNO testing provided the clarity they needed to understand and manage her symptoms.

Given her symptoms and family history – both of Leila’s parents have asthma and hay fever, and Leila herself has hay fever and eczema – asthma seemed likely. But her healthcare team wanted more evidence before making a formal diagnosis. Although spirometry is often recommended for assessing asthma, it’s not always easy for young children to perform. In Leila’s case, paediatric spirometry was not available at her clinic.

The Role of Peak Flow and FeNO Testing

To assess Leila’s symptoms, her doctors conducted a serial peak flow test, which measures airflow and can show changes in lung function over time. Leila’s results showed reversible airway obstruction after using a bronchodilator, indicating a likelihood of asthma. But even with this finding, her doctors wanted additional confirmation before starting treatment.

This is where FeNO (Fractional Exhaled Nitric Oxide) testing became useful. FeNO testing is particularly suitable for young children because it’s non-invasive and simple to perform, requiring only a gentle breath into the device.2 FeNO measures the level of nitric oxide in the breath, which is a marker of inflammation in the airways commonly associated with asthma.3,4

When Leila took the FeNO test, her nitric oxide level was elevated at 52 parts per billion (ppb), indicating airway inflammation. This result provided the confirmation her doctors needed, strongly suggesting that her symptoms were due to asthma.

Starting treatment with confidence

Leila’s doctors recommended starting her on an inhaled corticosteroid (ICS) to reduce inflammation in her airways. The FeNO results also reassured her parents about the diagnosis, helping them understand that the inflammation in her airways required regular treatment to keep it under control.

Planning for Ongoing Care

The plan was to continue monitoring Leila’s asthma, using FeNO testing periodically to confirm that her treatment was effectively managing the inflammation. Knowing they had an objective measure of her condition gave Leila’s parents peace of mind and helped them feel confident that she was on the right track for managing her asthma.

Why FeNO Testing is Ideal for Children

For Leila, FeNO testing offered a straightforward, child-friendly way to confirm her asthma diagnosis, and provided clear evidence of the inflammation present in her airways, which helped her parents feel secure about the need for treatment.

This case study is based on true events. Names and ages have been changed for confidentiality purposes.