Exercise-induced bronchoconstriction in children with atopic eczema

Abstract Non-specific bronchial hyper-responsiveness has been reported in most of the eczematous children even in the absence of asthmatic symptoms. We therefore investigated the occurrence of exercise-induced bronchoconstriction (EIB) in children with atopic eczema (AE) and the predictors of EIB. Fifty-five children referred to the paediatric clinic for AE and a control group of 17 healthy children were recruited. They all carried out a physical examination and skin prick test (SPT) both to inhalant and food allergens, prior to the exercise challenge test. Their parents filled a questionnaire on atopic diseases. They underwent exercise challenge test that consisted in free running for 6 min. Spirometric measurements were carried out before running and till 11 min after. Exercise challenge test was positive in 13 (23%) children with AE. None of the children in the control group had a positive exercise challenge test [OR (95% CI) = 1.31 (1.13-1.51); p = 0.030]. Sixteen (29%) eczematous children had a history of EIB. Such history was not reliable for identifying children who had a positive exercise test. Twenty-nine (52%) children with AE had asthma. Allergic rhinitis affected 33 (60%) of eczematous children and allergic conjunctivitis 28 (50%). EIB was not related to any history of asthma, allergic rhinitis, allergic conjunctivitis, severity of eczema or SPT results. Our study shows that EIB is common in children with AE. Our data also indicate that screening by medical history and physical examination is not a sensitive marker of EIB. This may explain why EIB is often ignored in eczematous children.