Misdiagnosis of Other Lung Diseases as Asthma:69 Cases Analysis_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

LiNaijian , QiuRihuang , HuangZhiyong , LiJing , ChenRongchang ,  ZhangQingling

First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Diseases, State Key Laboratory of Respiratory Diseases, Guangzhou, Guangdong, 510120, China;

Corresponding?author：

ZhangQingling, Email: zqling68@hotmail.com

Keywords：

Misdiagnosis; Bronchial asthma; Case analysis

DOI：

10.7507/1671-6205.2015007

Video：

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Objective To analyze misdiagnosis of other lung diseases as asthma to avoid medical error. Methods Sixty-nine cases who were misdiagnosed as asthma between February 2012 and February 2014 were recruited. Clinical data was collected and analyzed including characteristics of symptoms, induced sputum, pulmonary function and blood tests. Results There were 13 diseases misdiagnosed as asthma, and eosinophilic bronchitis(21.74%), upper airway cough syndrome(20.29%), chronic obstructive pulmonary disease(13.04%), allergic bronchopulmonary aspergillosis(7.25%) and hyperventilation syndrome (7.25%) were the top five diseases in these cases. Some rare diseases were also found such as idiopathic hypereosinophilic syndrome and vocal cord dysfunction. Conclusions A variety of diseases have the similar clinical symptoms with asthma. The key to avoid and reduce misdiagnosis is to strengthen the understanding of asthma and similar diseases.

Citation： LiNaijian, QiuRihuang, HuangZhiyong, LiJing, ChenRongchang, ZhangQingling. Misdiagnosis of Other Lung Diseases as Asthma:69 Cases Analysis. Chinese Journal of Respiratory and Critical Care Medicine, 2015, 14(1): 22-26. doi: 10.7507/1671-6205.2015007 Copy

1.	Zhang X, Morrison-Carpenter T, Holt JB, et al.Trends in adult current asthma prevalence and contributing risk factors in the United States by state:2000-2009.BMC Public Health, 2013, 13:1156.
2.	Li J, Wang H, Chen Y, et al.House dust mite sensitization is the main risk factor for the increase in prevalence of wheeze in 13 to 14 year-old schoolchildren in Guangzhou city, China.Clin Exp Allergy, 2013, 43:1171-1179.
3.	中華醫學會呼吸病學分會哮喘學組.支氣管哮喘防治指南.中華結核和呼吸雜志, 2008, 31:177-185.
4.	Vonk JM, Jongepier H, Panhuysen CM, et al.Risk factors associated with the presence of irreversible airflow limitation and reduced transfer coeffieient in patients with asthma after 26 years of follow up.Thorax, 2003, 58:322-327.
5.	Gibson PG, Simpson JL.The overlap syndrome of asthma and COPD:what are its feature and how important is it? Thorax, 2009, 64:728-735.
6.	秦茵茵, 吳國鋒, 謝燕清.老年患者慢性阻塞性肺疾病和哮喘臨床分析.中國呼吸與危重監護雜志, 2012, 11:111-115.
7.	Shaw DE, Berry MA, Hargadon B, et al.Association between neutrophilie airway inflammation and airfiow limitation in adults with asthma.Chest, 2007, 132:1871-1875.
8.	Busacker A, Newell JD, Keefe T, et al.A multivariate analysis of risk factors for the air-trapping asthmatic phenotype as measured by quantitative CT analysis.Chest, 2009, 135:48-56.
9.	Tsuda Y, Noguchi T, Mochizukj H, et al.Patients with mild-to-moderate asthrna may develop clinically significant chronic obstructive pulmonary disease.Respirology, 2009, 14:529-536.
10.	Bleecker ER.Similarities and differenees in asthma and COPD.The Dutch hypothesis.Chest, 2004, 126:93S-95S.
11.	羅煒, 賴克芳, 陳如沖, 等.嗜酸粒細胞性支氣管炎患者氣道炎癥細胞及介質的探討.中華結核和呼吸雜志, 2005, 28:626-629.
12.	Brightling CE, Symon FA, Birring SS, et al.Comparison of airway immunopathology of eosinophilic bronchitis and asthma.Thorax, 2003, 58:528-532.
13.	Woodman L, Sutcliffe A, Kaur D, et al.Chemokine concentrations and mast cell chemotactic activity in BAL fluid in patients with eosinophilic bronchitis and asthma, and in normal control subjects.Chest, 2006, 130:371-378.
14.	Brighding CE, Bradding P, Symon FA, et al.Mast-cell infiltration of airway smooth muscle in asthma.N Engl J Med, 2002, 346:1699-1705.
15.	Berry MA, Hagadon B, McKenna S, et al.Observational study of the natural history of eosinophilic bronchitis.Clin Exp Anergy, 2005, 35:598-601.
16.	Bahrainwala AH, Simon MR.Wheezing and vocal cord dysfunction mimicking asthma.Curr Opin Pulm Med, 2001, 7:8-13.
17.	Kenn K, Willer G, Bizer C, et al.Prevalence of vocal cord dysfunction in patients with dyspnea:first prospective clinical study, abstracted.Am J Respir Crit Care Med, 1997, 155:A965.
18.	Parsons JP, Benninger C, Hawley MP, et al.Vocal cord dysfunction:Beyond severe asthma.Respir Med, 2010, 104:504-509.
19.	Traister RS, Fajt ML, Whitman-Purves E, et al.A retrospective analysis comparing subjects with isolated and coexistent vocal cord dysfunction and asthma.Allergy Asthma Proc, 2013, 34:349-355.
20.	Newman KB, Mason UG, Schmaling KB.Clinical features of vocal cord dysfunction.Am J Respir Crit Care Med, 1995, 152:1382-1386.
21.	Kenn K, Hess MM.Vocal cord dysfunction:an important differential diagnosis of bronchial asthma.Dtsch Arztebl Int, 2008, 105:699-704.
22.	Noyes BE, Kemp JS.Vocal cord dysfunction in children.Paediatr Respir Rev, 2007, 8:155-163.
23.	Moss RB.Management of allergic aspergillpsia.Current Fungal Infection Reports, 2008, 2:87-93.
24.	龔傳鵬, 向東方, 張淑芳.108首發癔癥患者的臨床特征及3年隨訪研究.中國神經精神疾病雜志, 2006, 32:239.
25.	Denning DW, Pleuvry A, Cole DC.Global burden of allergic bronchopulmonary aspergillosis with asthma and its complication chronic pulmonary aspergillosis in adults.Med Mycol, 2013, 51:361-370.

1. Zhang X, Morrison-Carpenter T, Holt JB, et al.Trends in adult current asthma prevalence and contributing risk factors in the United States by state:2000-2009.BMC Public Health, 2013, 13:1156.
2. Li J, Wang H, Chen Y, et al.House dust mite sensitization is the main risk factor for the increase in prevalence of wheeze in 13 to 14 year-old schoolchildren in Guangzhou city, China.Clin Exp Allergy, 2013, 43:1171-1179.
3. 中華醫學會呼吸病學分會哮喘學組.支氣管哮喘防治指南.中華結核和呼吸雜志, 2008, 31:177-185.
4. Vonk JM, Jongepier H, Panhuysen CM, et al.Risk factors associated with the presence of irreversible airflow limitation and reduced transfer coeffieient in patients with asthma after 26 years of follow up.Thorax, 2003, 58:322-327.
5. Gibson PG, Simpson JL.The overlap syndrome of asthma and COPD:what are its feature and how important is it? Thorax, 2009, 64:728-735.
6. 秦茵茵, 吳國鋒, 謝燕清.老年患者慢性阻塞性肺疾病和哮喘臨床分析.中國呼吸與危重監護雜志, 2012, 11:111-115.
7. Shaw DE, Berry MA, Hargadon B, et al.Association between neutrophilie airway inflammation and airfiow limitation in adults with asthma.Chest, 2007, 132:1871-1875.
8. Busacker A, Newell JD, Keefe T, et al.A multivariate analysis of risk factors for the air-trapping asthmatic phenotype as measured by quantitative CT analysis.Chest, 2009, 135:48-56.
9. Tsuda Y, Noguchi T, Mochizukj H, et al.Patients with mild-to-moderate asthrna may develop clinically significant chronic obstructive pulmonary disease.Respirology, 2009, 14:529-536.
10. Bleecker ER.Similarities and differenees in asthma and COPD.The Dutch hypothesis.Chest, 2004, 126:93S-95S.
11. 羅煒, 賴克芳, 陳如沖, 等.嗜酸粒細胞性支氣管炎患者氣道炎癥細胞及介質的探討.中華結核和呼吸雜志, 2005, 28:626-629.
12. Brightling CE, Symon FA, Birring SS, et al.Comparison of airway immunopathology of eosinophilic bronchitis and asthma.Thorax, 2003, 58:528-532.
13. Woodman L, Sutcliffe A, Kaur D, et al.Chemokine concentrations and mast cell chemotactic activity in BAL fluid in patients with eosinophilic bronchitis and asthma, and in normal control subjects.Chest, 2006, 130:371-378.
14. Brighding CE, Bradding P, Symon FA, et al.Mast-cell infiltration of airway smooth muscle in asthma.N Engl J Med, 2002, 346:1699-1705.
15. Berry MA, Hagadon B, McKenna S, et al.Observational study of the natural history of eosinophilic bronchitis.Clin Exp Anergy, 2005, 35:598-601.
16. Bahrainwala AH, Simon MR.Wheezing and vocal cord dysfunction mimicking asthma.Curr Opin Pulm Med, 2001, 7:8-13.
17. Kenn K, Willer G, Bizer C, et al.Prevalence of vocal cord dysfunction in patients with dyspnea:first prospective clinical study, abstracted.Am J Respir Crit Care Med, 1997, 155:A965.
18. Parsons JP, Benninger C, Hawley MP, et al.Vocal cord dysfunction:Beyond severe asthma.Respir Med, 2010, 104:504-509.
19. Traister RS, Fajt ML, Whitman-Purves E, et al.A retrospective analysis comparing subjects with isolated and coexistent vocal cord dysfunction and asthma.Allergy Asthma Proc, 2013, 34:349-355.
20. Newman KB, Mason UG, Schmaling KB.Clinical features of vocal cord dysfunction.Am J Respir Crit Care Med, 1995, 152:1382-1386.
21. Kenn K, Hess MM.Vocal cord dysfunction:an important differential diagnosis of bronchial asthma.Dtsch Arztebl Int, 2008, 105:699-704.
22. Noyes BE, Kemp JS.Vocal cord dysfunction in children.Paediatr Respir Rev, 2007, 8:155-163.
23. Moss RB.Management of allergic aspergillpsia.Current Fungal Infection Reports, 2008, 2:87-93.
24. 龔傳鵬, 向東方, 張淑芳.108首發癔癥患者的臨床特征及3年隨訪研究.中國神經精神疾病雜志, 2006, 32:239.
25. Denning DW, Pleuvry A, Cole DC.Global burden of allergic bronchopulmonary aspergillosis with asthma and its complication chronic pulmonary aspergillosis in adults.Med Mycol, 2013, 51:361-370.

Chinese Journal of Respiratory and Critical Care Medicine

Misdiagnosis of Other Lung Diseases as Asthma:69 Cases Analysis

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