Chronic airways infection and inflammation are leading causes of morbidity and mortality in chronic lung diseases (CLD). Pulmonary exacerbations are major causes of morbidity in CLD. Exhaled carbon monoxide (eCO) is a product of endogenous metabolic processes whose presence in exhaled breath is considered an index of inflammatory processes. Objective. To evaluate carbon monoxide (eCO) as inflammatory marker for early detection of acute exacerbation in CLD. Methods. Case control study included 40 children with CLD (twenty in exacerbation, group I and twenty in quiescent period, group II) recruited from the Chest Clinic, Children's Hospital, Ain Shams University. Twenty apparently healthy children were included as controls (group III). Results. Patients' mean age was 9.98 ± 3.29 years: 24 (60%) males and 16 (40%) females. The mean eCO level among patients during exacerbation was 5.35 ± 1.35 (ppm) compared to 2.65 ± 0.49 (ppm) in quiescent stage and 1.30 ± 0.47 (ppm) in controls. eCO cutoff value discriminating cases and control was 1.5 (ppm) (sensitivity; 100% and specificity 70%) and cutoff value discriminating group I from group II was 3 (ppm) (sensitivity: 100% and specificity: 100%). Conclusion. Exhaled CO can be considered a noninvasive early marker of acute exacerbation of CLD.

This study was undertaken to evaluate the effect of triiodothyronine, determined by pulmonary function tests and c-AMP plasma and sputum levels, in asthmatic children. Twenty-three children clinically euthyroid and complaining of chronic bronchial asthma were given a triiodothyronine (T3) supply for a period of 30 days. Pulmonary function tests, plasma and sputum cyclic AMP and plasma T3 levels were performed prior to and after T3 therapy. Patients were requested to continue on their usual antiasthma medicines and to try reduction of the doses of the drugs they needed as possible. All patients tolerated well the T3 regimen without any adverse effect. They all reported at the end of the 30 days an obvious subjective improvement of their asthmatic conditions with a decrease in the number of exacerbations. Seven patients stopped their usual antiasthmatic medicines, being maintained on T3 only and 3 have decreased the amount of bronchodilators needed. A significant improvement of pulmonary function tests was noted in all patients. Also, significantly increased levels of plasma and sputum c-AMP were observed after T3 administration in comparison to the control and pretest values. No statistical differences were found in plasma T3 between the control and the patients either before or after T3 therapy. The study revealed that T3 administration to clinically euthyroid chronic asthmatic children induced a beneficial effect. This might be through improvement of c-AMP synthesis. T3 in the doses used is devoid of side effects, proves to be a useful adjuvant to classic antiasthma therapy, and may reduce the amount of bronchodilators needed.