Summary

Introduction. FeNO is a non-invasive biomarker of eosinophilic airway inflammation increasingly used during pediatric asthma follow-up, although it may not always correlate with symptoms and lung function.

Materials and methods. We describe a 12-year-old boy with allergic asthma and allergic rhinitis in outpatient follow-up.

Results. Despite good clinical control and normal spirometry, FeNO remained elevated; optimization of nasal therapy led to FeNO reduction.

Discussion and Conclusions. FeNO should be interpreted within the global clinical context to avoid overtreatment, thereby supporting the united airways disease concept

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Authors

Salvatore Cascone - Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

Angela Klain - Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

Giulio Dinardo - Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

Carolina Grella - Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

Nicola Montinaro - Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

Giorgio Iaccarino - Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Italy

Fabio Decimo - Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

Cristiana Indolfi - Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

Michele Miraglia Del Giudice - Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

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Copyright (c) 2026 Italian Journal of Pediatric Allergy and Immunology

How to Cite
Cascone, S., Klain , A. ., Dinardo, G. ., Grella, C., Montinaro, N., Iaccarino, G., Decimo, F., Indolfi, C. ., & Miraglia Del Giudice, M. (2026). Persistent FeNO Elevation Despite Clinical Control in Pediatric Allergic Asthma: a Case Report Emphasizing the Impact of Allergic Rhinitis. Italian Journal of Pediatric Allergy and Immunology, 67(2). https://doi.org/10.53151/2531-3916/2026-2432
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