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The dangers of widespread nitric oxide screening for primary ciliary dyskinesia
  1. Samuel A Collins1,2,3,
  2. Laura Behan1,2,3,
  3. Amanda Harris1,3,
  4. Kerry Gove2,3,
  5. Jane S Lucas1,2,3
  1. 1Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  2. 2Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK
  3. 3NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
  1. Correspondence to Dr Samuel Collins, Faculty of Medicine, MP810, LF100, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; samuel.collins{at}soton.ac.uk

Abstract

Primary ciliary dyskinesia (PCD) is underdiagnosed and requires complex testing at specialist diagnostic centres. Measurement of nasal nitric oxide (nNO) has good sensitivity and specificity screening for PCD, but is currently usually measured at PCD centres rather than prior to referral. Proposals to include NO testing for asthma diagnoses could widen access to PCD screening if nasal mode analysers are available. Data from 282 consecutive referrals to our PCD diagnostic centre (31 PCD positive) were used to model predictive values for nNO testing with varying pretest probability and showed that predictive values were good in the referral population, but extending screening to more general populations would result in excessive false positives that may overwhelm diagnostic services. Although nNO remains a useful test, a ‘normal’ result with classical clinical history should still be considered for further testing.

  • Rare lung diseases
  • Asthma
  • Exhaled Airway Markers

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