Asthma without Wheezing

Farr, Richard S.; Kopetzky, Michael T.; Spector, Sheldon L.; Hurewitz, David

doi:10.1378/chest.63.4_supplement.64s

Cited by 23 publications

(15 citation statements)

References 9 publications

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“…Among the 13 patients with CTRB, the VC was 3,569 ± 1,239 mL, the predicted VC% was 124.9% ± 16.2%, the FEV1 was 2,864 ± 1,064 mL, the predicted FEV1% was 124.1% ± 21.2%, the PEF was 5,968 ± 1,847 mL/s, the predicted PEF% was 77.2% ± 14.1%, and the FEV 1 /FVC ratio was 80. 9…”

Section: Pulmonary Function Datamentioning

confidence: 99%

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Chest tightness is relieved with the use of asthma drugs except bronchodilators

et al. 2018

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Objective: Many patients with a chief complaint of chest tightness are examined in medical facilities, and a lack of diagnosis is not uncommon. We have reported that these patients often include those with chest tightness relieved with bronchodilator use (CTRB) and those with chest tightness relieved with the use of asthma drugs except bronchodilators (CTRAEB). The purpose of this study was to demonstrate the clinical characteristics of the patients with CTRAEB and compare them with data from patients with CTRB. Methods: Patients with CTRB (n ¼ 13) and CTRAEB (n ¼ 7) underwent a bronchodilator test, assessments of airway responsiveness to methacholine, bronchial biopsy, and bronchial lavage under fiberoptic bronchoscopy before receiving treatment. In all, 10 healthy subjects, 11 bronchial biopsy control patients, and 10 asthmatic patients were recruited for comparison. Results: Inhalation of a short-acting ß 2-agonist (SABA) increased the forced expiratory volume in one second (FEV 1) by 5.1% ± 4.0% in patients with CTRB and by 1.3% ± 3.5% in patients with CTRAEB, and the difference was statistically significant (p ¼ 0.0449). The bronchial biopsy specimens from the patients with CTRB and CTRAEB exhibited significant increases in T cells (p < .05) compared with those of the control subjects. The bronchial responsiveness to methacholine was increased in only a minor portion of patients with CTRB and CTRAEB. Conclusions: We hypothesized that the clinical condition of patients with CTRAEB involves chest tightness arising from inflammation alone, and this chest tightness is mostly associated with airway T cells, without constriction of the airways. There is little to distinguish CTRAEB from CTRB aside from the response to bronchodilator treatment. This clinical trial is registered at www.umin.ac.jp (UMIN13994, 13998, and 16741).

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Section: Pulmonary Function Datamentioning

confidence: 99%

“…Patients with classic BA often experience chest tightness [9]. In the Global Initiative for Asthma (GINA) guidelines, chest tightness is listed as a symptom of asthma [10].…”

Section: Introductionmentioning

confidence: 99%

Chest tightness is relieved with the use of asthma drugs except bronchodilators

et al. 2018

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“…132 It can present as dyspnea without wheezing. [133][134][135] Although most physicians appreciate the prevalence of asthma, they often fail to recognize the pitfalls of clinical diagnosis. 136 As discussed subsequently, the key to the diagnosis of asthma is objective testing, including the use of bronchoprovocation.…”

Section: Lower Airway Disordersmentioning

confidence: 99%

A Clinical Approach to Chronic Dyspnea

Pratter

Bartter

Akers

et al. 2006

Clinical Pulmonary Medicine

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Dyspnea is a common and important symptom. A small number of categories of disease cause the majority of cases, but the full differential diagnosis is vast. Given the large number of potential causes and the many possible diagnostic tests, an organized approach to the workup of dyspnea is crucial. This article outlines the spectrum of potential causes of dyspnea, the relative use of various diagnostic tests, and suggests a tiered approach to diagnosis.

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“…Because of the considerations just outlined, I feel the only universal definition of asthma can be "reversible obstructive airways disease of unknown etiology until proved otherwise." 9 This is a very heterogeneous population of patients, wheezing on auscultation of the chest need not be present, 10 and certainly known asthma need not be accompanied by any of the currently recognized allergic states. This definition in no way conflicts with other definitions because various degrees of asthma can be associated with and aggravated by such conditions as chronic bronchitis, sinusitis, sinusitis associated with bronchitis, emphysema, or infections, even indolent infections such as tuberculosis.…”

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confidence: 99%

“…15 In addition, most asthmatic subjects have significant "trapped air volumes" as measured by differences between lung volumes determined by the body plethysmograph and values obtained by helium dilution techniques. 10 It is important to note that the presence or absence of a significant trapped air volume does not necessarily correlate with the severity of the asthma.…”

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confidence: 99%

Definition and Heterogeneity of Asthma

Farr¹

1987

Semin Respir Crit Care Med

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Asthma without Wheezing

Cited by 23 publications

References 9 publications

Chest tightness is relieved with the use of asthma drugs except bronchodilators

Chest tightness is relieved with the use of asthma drugs except bronchodilators

A Clinical Approach to Chronic Dyspnea

Definition and Heterogeneity of Asthma

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