Nadia, a woman in her mid-20s, had struggled with a persistent cough and shortness of breath for years. Despite seeing several doctors and trying various treatments, her symptoms continued to disrupt her life, waking her at night and leaving her breathless after simple activities.
Misdiagnoses and Frustration
For years, Nadia’s symptoms were mistaken for recurring chest infections. She had been prescribed antibiotics multiple times, but the relief was temporary, and her symptoms quickly returned. When she tried Salbutamol and prednisolone, her symptoms improved for a short time, but no one had formally diagnosed her with asthma.
To better understand her condition, Nadia’s doctor conducted several tests, including spirometry and a peak flow diary. While her spirometry results came back normal, her peak flow diary showed significant variability, with over 20% variation in her readings. This fluctuation hinted that asthma might be the underlying issue. The next step was FeNO (Fractional Exhaled Nitric Oxide) testing, which measures the level of nitric oxide in the breath, a sign of airway inflammation commonly associated with asthma.2
When Nadia’s FeNO results came in, her nitric oxide level was 126 parts per billion (ppb), indicating airway inflammation, suggesting asthma was the cause for her symptoms.
A Life-Changing Outcome
With her asthma diagnosis confirmed, Nadia’s doctors started her on an inhaled corticosteroid (ICS) to reduce inflammation.
Within a few weeks of starting treatment, Nadia noticed her symptoms had reduced and she was feeling much better. During her follow-up appointment, a repeat FeNO test showed that her nitric oxide levels had returned to normal, confirming that the inflammation in her airways was now under control.
For Nadia, FeNO testing was the breakthrough she had been waiting for, finally pinpointing the cause of her symptoms. Her FeNO results, combined with her peak flow diary and medical history, gave her healthcare team the evidence they needed to make an accurate asthma diagnosis. This approach allowed them to create a tailored treatment plan that helped improve Nadia’s quality of life.
This case study is based on true events. Names and ages have been changed for confidentiality.