What Is the Best Pulmonary Diagnostic Approach for Wheezing Patients With Normal Spirometry?

Respir Care. 2012 Jan;57(1):39-46; discussion 47-9. doi: 10.4187/respcare.01449.


Asthma is characterized by airway inflammation, airway hyper-responsiveness (AHR) and variable air flow obstruction. The diagnosis of asthma, however, is often based upon nonspecific clinical symptoms of cough, wheeze, and shortness of breath. Furthermore, the physical examination and measurements of pulmonary function are often unremarkable in patients with asthma, thereby complicating the diagnosis of the disease. The following discussion will review approaches to the diagnosis of asthma when lung functions are normal, and will largely focus on the use of bronchial provocation tests to detect underlying AHR.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Asthma / diagnosis*
  • Asthma / physiopathology*
  • Bronchial Hyperreactivity / diagnosis
  • Bronchial Hyperreactivity / physiopathology
  • Bronchial Provocation Tests
  • Diuretics, Osmotic
  • Female
  • Forced Expiratory Volume
  • Humans
  • Mannitol
  • Respiratory Function Tests*
  • Respiratory Sounds / physiology
  • Spirometry


  • Diuretics, Osmotic
  • Mannitol