Asthma differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Philip Marcus, M.D., M.P.H. [2] Associate Editor(s)-in-Chief:
Overview
Asthma must be clinically differentiated from other conditions that cause recurrent cough and wheezing such as viral bronchiolitis, chronic obstructive pulmonary disease, congestive heart failure, vocal cord dysfunction, ACE inhibitors use and allergic rhinitis.[1][2]
Differentiating Asthma from other Diseases
- Although, many cases of recurrent cough and wheezing in children and adults are due to asthma, other conditions are often misdiagnosed as asthma.[1][3][4][5][6]
Adults
- Chronic obstructive pulmonary disease (COPD)
- Hyperventilation syndrome and panic attacks
- Congestive heart failure
- Pulmonary embolism
- Laryngeal dysfunction
- Pulmonary aspiration
- Mechanical obstruction of the airways (benign and malignant tumors)
- Pulmonary infiltration with eosinophilia
- Diffuse parenchymal lung diseases
- Cough, secondary to drugs (ACE inhibitors)[2]
- Vocal cord dysfunction[3]
- Pharyngitis
Infants & Children
Upper airway diseases
Obstructions involving large airways
- Foreign body in trachea or bronchus
- Vocal cord dysfunction
- Vascular rings or laryngeal webs
- Laryngotracheomalacia, tracheal stenosis, or bronchostenosis
- Enlarged lymph nodes or tumor[3]
Obstructions involving small airways
Other causes
- Congenital heart diseases
- Recurrent cough not due to asthma
- Aspiration from swallowing mechanism
- Gastroesophageal reflux[3]
References
- ↑ 1.0 1.1 Liu WY, Yu Q, Yue HM, Zhang JB, Li L, Wang XY; et al. (2016). "[The distribution characteristics of etiology of chronic cough in Lanzhou]". Zhonghua Jie He He Hu Xi Za Zhi. 39 (5): 362–7. doi:10.3760/cma.j.issn.1001-0939.2016.05.006. PMID 27180590.
- ↑ 2.0 2.1 Wrona W, Budka K, Filipiak KJ, Niewada M, Wojtyniak B, Zdrojewski T (2016). "Health outcomes and economic consequences of using angiotensin-converting enzyme inhibitors in comparison with angiotensin receptor blockers in the treatment of arterial hypertension in the contemporary Polish setting". Kardiol Pol. 74 (9): 1016–24. doi:10.5603/KP.a2016.0055. PMID 27112942.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Environmental Triggers of Asthma. Differential Diagnosis of Asthma. Environmental Health and Medicine Education. Agency for Toxic Substances and Disease Registry. Available at: http://www.atsdr.cdc.gov/csem/csem.asp?csem=32&po=5. Accessed on February 25, 2016
- ↑ Mosley JD, Shaffer CM, Van Driest SL, Weeke PE, Wells QS, Karnes JH; et al. (2016). "A genome-wide association study identifies variants in KCNIP4 associated with ACE inhibitor-induced cough". Pharmacogenomics J. 16 (3): 231–7. doi:10.1038/tpj.2015.51. PMC 4713364. PMID 26169577.
- ↑ Jiang S, Li J, Zeng Q, Liang J (2017). "Pulmonary artery intimal sarcoma misdiagnosed as pulmonary embolism: A case report". Oncol Lett. 13 (4): 2713–2716. doi:10.3892/ol.2017.5775. PMC 5403205. PMID 28454456.
- ↑ Lin L, Chen Z, Cao Y, Sun G (2017). "Normal saline solution nasal-pharyngeal irrigation improves chronic cough associated with allergic rhinitis". Am J Rhinol Allergy. 31 (2): 96–104. doi:10.2500/ajra.2017.31.4418. PMID 28452705.