Published online October 1, 2007
PEDIATRICS Vol. 120 No. 4 October 2007, pp. 855-864 (doi:10.1542/peds.2007-0078)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Video
Right arrow P3Rs: Submit a response
Right arrow P3Rs: View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (5)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Weinberger, M.
Right arrow Articles by Abu-Hasan, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Weinberger, M.
Right arrow Articles by Abu-Hasan, M.
Related Collections
Right arrow Genetics & Dysmorphology

REVIEW ARTICLE

Pseudo-asthma: When Cough, Wheezing, and Dyspnea Are Not Asthma

Miles Weinberger, MD and Mutasim Abu-Hasan

Pediatric Allergy and Pulmonary Division, Department of Pediatrics, University of Iowa, Iowa City, Iowa

Although asthma is the most common cause of cough, wheeze, and dyspnea in children and adults, asthma is often attributed inappropriately to symptoms from other causes. Cough that is misdiagnosed as asthma can occur with pertussis, cystic fibrosis, primary ciliary dyskinesia, airway abnormalities such as tracheomalacia and bronchomalacia, chronic purulent or suppurative bronchitis in young children, and habit-cough syndrome. The respiratory sounds that occur with the upper airway obstruction caused by the various manifestations of the vocal cord dysfunction syndrome or the less common exercise-induced laryngomalacia are often mischaracterized as wheezing and attributed to asthma. The perception of dyspnea is a prominent symptom of hyperventilation attacks. This can occur in those with or without asthma, and patients with asthma may not readily distinguish the perceived dyspnea of a hyperventilation attack from the acute airway obstruction of asthma. Dyspnea on exertion, in the absence of other symptoms of asthma or an unequivocal response to albuterol, is most likely a result of other causes. Most common is the dyspnea associated with normal exercise limitation, but causes of dyspnea on exertion can include other physiologic abnormalities including exercise-induced vocal cord dysfunction, exercise-induced laryngomalacia, exercise-induced hyperventilation, and exercise-induced supraventricular tachycardia. A careful history, attention to the nature of the respiratory sounds that are present, spirometry, exercise testing, and blood-gas measurement provide useful data to sort out the various causes and avoid inappropriate treatment of these pseudo-asthma clinical manifestations.

Key Words: asthma • cough • wheezing • dyspnea

Accepted May 4, 2007.




This article has been cited by other articles:


Home page
 PediatricsHome page
R. D. Anbar
Pseudo-asthma Revisited
Pediatrics, January 1, 2008; 121(1): 221 - 221.
[Full Text] [PDF]

P3Rs:

Read all P3Rs

The overdiagnosis of pediatric asthma.
Michael Seear, et al.
Pediatrics Online, 5 Oct 2007 [Full text]