Asthma classification: Difference between revisions
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Revision as of 13:33, 1 June 2016
Asthma Microchapters |
Diagnosis |
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Other Diagnostic Studies |
Treatment |
Case Studies |
Asthma classification On the Web |
American Roentgen Ray Society Images of Asthma classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]
Overview
Asthma is classified into atopic and non-atopic types based on the onset of symptoms. Atopic refers to early-onset whereas non-atopic refers to late-onset. Despite the differentiation, a significant degree of overlap exists between the two types. The severity of symptoms is further classified based on the GINA severity grades into mild intermittent, mild persistent, moderate persistent and severe persistent asthma.
Classification
Based on Symptom Onset
Early-onset Asthma (Atopic, Allergic, Extrinsic)
- Early-age of onset
- Atopic individuals have an increased predisposition
- Environmental allergens play a strong role in the pathogenesis
- Positive personal and/or family history of atopic diseases such as allergic rhinitis, urticaria and eczema
- Laboratory tests may reveal increased serum IgE levels, positive skin test to specific aero-allergens and a positive bronchoprovocation test
Late-onset Asthma (Non-Atopic, Idiosyncratic, Intrinsic)
- Late-age of onset
- Non- atopic individuals have an increased predisposition
- Indoor allergens play a strong role in the pathogenesis
- Negative personal and/or family history of allergic diseases
- Laboratory tests may reveal normal serum IgE levels and a negative bronchoprovocation test
Based on GINA Severity Grade
Asthma is classified into four subgroups: mild intermittent, mild persistent, moderate persistent and severe persistent based on the Global Initiative for Asthma - GINA severity grades.[1]
Mild Intermittent Asthma
Symptoms per day | Symptoms at night | PEF or FEV1 | PEF variability |
|
Less than or equal to twice a month | ≥ 80% of predicted normal | < 20% |
Mild Persistent Asthma
Symptoms per day | Symptoms at night | PEF or FEV1 | PEF variability |
|
Greater than or equal to twice a month | ≥ 80% | 20-30% |
Moderate Persistent Asthma
Symptoms per day | Symptoms at night | PEF or FEV1 | PEF variability |
|
More than once a month | 60-80% | ≥ 30% |
Severe Persistent Asthma
Symptoms per day | Symptoms at night | PEF or FEV1 | PEF variability |
|
Frequent | ≤ 60% | ≥ 30% |
Guidelines for Diagnosis and Management of Asthma Based On The National Heart, Blood, and Lung Institute Expert Panel Report 3 (EPR3) [2]
References
- ↑ Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald M et al. (2008) Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J 31 (1):143-78. DOI:10.1183/09031936.00138707 PMID: 18166595
- ↑ Urbano FL (2008) Review of the NAEPP 2007 Expert Panel Report (EPR-3) on Asthma Diagnosis and Treatment Guidelines. J Manag Care Pharm 14 (1):41-9. PMID: 18240881