Objective: To investigate the usefulness of laboratory testing and thorax radiography in children, referred to the paediatrician for evaluation of recurrent wheezing.
Design: Retrospective.
Methods: In this study, 158 children referred for recurrent wheezing to a specialized child outpatient clinic of the Medisch Centrum Leeuwarden, the Netherlands, in the period 1 January 1994-31 December 1996, were evaluated according to a routine protocol including haemoglobin, ESR, leucocytes, immunoglobulins, sweat chloride levels and allergy testing and chest roentgenograms. It was determined whether these investigations had yielded abnormal results and whether these test results aided in confirming/rejecting the diagnosis of asthma or were helpful in clinical management.
Results: In 144 of the 158 (91%) children the diagnosis 'asthma' or 'recurrent wheezing' was made. Although numerous test results were abnormal they were not helpful in establishing the diagnosis. In only one child an abnormal chest radiograph was helpful (the radiograph showed infiltrative abnormalities). Tests for aero-allergy were rarely positive in children younger than 2 years; in children older than 6 years aero-allergy was found frequently, notably to dust mite (41/144).
Conclusion: The results of this study suggest that--except for allergy testing--routine laboratory testing and chest roentgenograms are not indicated in children referred for evaluation of wheezing disorders. Aero-allergy testing may help to decide on preventive measures.