Methacholine Challenge Test as an Adjunctive Investigative Tool in Patients with Asthma-Like Symptoms: The Sabah Experience
- Author:
Siew Teck Tie
;
J L Wong
;
A Beniyamin
;
A HO
;
S K K Kannan
;
A R Jamalul Azizi
- Publication Type:Journal Article
- From:
The Medical Journal of Malaysia
2012;67(2):204-206
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Patients with asthma-like symptoms pose a
diagnostic dilemma when physical examination is normal.
The usual practice in Malaysia would be to give empirical
asthma treatment. Bronchial challenge test (BCT) is widely
used in many countries to diagnose asthma objectively but it is not widely available in Malaysia.
Objective: To describe our experience with BCT using
methacholine at Queen Elizabeth Hospital as a supporting
tool in the investigation of patients with asthma-like
symptoms.
Methodology: Review of case notes of patients who
underwent BCT from July 2008 till April 2009. BCT was
performed via dosimeter technique. Results were classified
as high hyper responsiveness if the provocative dose of
methacholine required to achieve 20% fall in FEV1 (PD20) was less than or equal to 0.125 μmol, moderate hyper
responsiveness if PD20 was between 0.125 to 1.99 μmol or
mild hyper responsiveness if PD20 was between 2.00 to 6.6
μmol. PD20 of more than 6.6 μmol constitutes a negative MCT.
Results: 29 patients had BCT during the study period. 19
cases were included in this review. The age ranged from 13
to 70 years old. There were 12 males and 7 females. Duration of symptoms ranged from 2 weeks to 23 years. BCT was positive (mild or moderate hyper responsiveness) in 10 out of 19 patients. No patient had high bronchial hyper
responsiveness.
Conclusions: BCT is a useful adjunctive tool in the
investigation of patients presenting with asthma-like
symptoms. This test obviates empirical asthma treatment.
BCT should be made available in all major hospitals in
Malaysia.
