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. 1. Introduction Chronic lung diseases (CLDs) including cystic fibrosis, asthma, chronic obstructive pulmonary disease (COPD), and other types of bronchiectasis represent a major challenge for health care [1]. Chronic infection and inflammation of the airways are the leading causes of morbidity and mortality in CLD [2]. Pulmonary exacerbations are a major cause of morbidity and decreased quality of life for patients with chronic lung diseases [3]. Exhaled breath analysis has enormous potential as an easy, non invasive means of monitoring inflammation and oxidative stress in the airway [4]. CO represents a product of endogenous metabolic processes whose presence on exhaled breath is considered as indices of inflammatory processes [5]. Exhaled Co not only can be used as an oxidative stress marker, but also can reflect the severity of chronic lung diseases (CLD). Also exhaled CO could serve as an indicator of acute exacerbations in children with CLD [6]. 1.1. Aim of the Work The present study aimed to detect the diagnostic value of carbon monoxide (CO) as inflammatory marker for early detection of acute exacerbation of chronic lung diseases. 2. Patients and Method 2.1. Study Case control study was carried at the Chest Clinic, Children’s hospital, Ain Sham University in the period
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