Ground zero: not asthma at all

Pediatr Allergy Immunol. 2015 Sep;26(6):490-6. doi: 10.1111/pai.12421.

Abstract

Upper airway obstruction is commonly misdiagnosed as asthma. We report on four children with recurrent respiratory symptoms who had been erroneously diagnosed as having asthma and who received anti-asthma medication for several years. The evaluation of spirometry tracing was neglected in all cases. Subglottic stenosis, tracheomalacia secondary to tracheo-esophageal fistula, double aortic arch, and vocal cord dysfunction were suspected by direct inspection of the flow-volume curves and eventually diagnosed. The value of clinical history and careful evaluation of spirometry tracing in children with persistent respiratory symptoms is critically discussed.

Keywords: asthma; children; flow-volume curves; spirometry.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Airway Obstruction / diagnosis
  • Airway Obstruction / etiology*
  • Airway Obstruction / physiopathology
  • Airway Obstruction / therapy
  • Anti-Asthmatic Agents / therapeutic use
  • Asthma / complications*
  • Asthma / diagnosis
  • Asthma / drug therapy
  • Asthma / physiopathology
  • Bronchoscopy
  • Child
  • Diagnosis, Differential
  • Diagnostic Errors
  • Female
  • Humans
  • Lung / drug effects
  • Lung / physiopathology*
  • Magnetic Resonance Angiography
  • Male
  • Predictive Value of Tests
  • Risk Factors
  • Spirometry
  • Treatment Outcome
  • Unnecessary Procedures

Substances

  • Anti-Asthmatic Agents