Triggers of breathlessness in inducible laryngeal obstruction and asthma.
Adult
Aged
Airway Obstruction
/ complications
Asthma
/ complications
Comorbidity
Diagnosis, Differential
Dyspnea
/ diagnosis
Environmental Exposure
/ adverse effects
Female
Humans
Laryngeal Diseases
/ complications
Lung
/ physiopathology
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Retrospective Studies
Risk Factors
Self Report
allergens and epitopes
asthma
environment
hygiene hypothesis and Inducible laryngeal obstruction
Journal
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
ISSN: 1365-2222
Titre abrégé: Clin Exp Allergy
Pays: England
ID NLM: 8906443
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
received:
21
02
2020
revised:
08
07
2020
accepted:
14
07
2020
pubmed:
28
7
2020
medline:
3
11
2021
entrez:
27
7
2020
Statut:
ppublish
Résumé
Inducible laryngeal obstruction (ILO) is often misdiagnosed as, or may coexist with, asthma. Identifying differences in triggering factors may assist clinicians to differentiate between the two conditions and could give mechanistic insights. To identify and compare patient-reported triggers in ILO and asthma. This was a two-part study. Initially, we conducted a retrospective case note review of the triggers of ILO from endoscopically confirmed ILO patients to generate a Breathlessness Triggers Survey (BrTS). Triggers were categorized as scents, environmental factors, temperature, emotions, mechanical factors and daily activities. Secondly, ILO and/or asthma patients completed the BrTS prospectively, rating the likelihood of each item triggering their symptoms using a five-point Likert scale (strongly disagree to strongly agree). Chi-square testing was performed to compare responses by cohort. Data from 202 patients with ILO [73% female, mean (SD) age 53(16) years] were included in the case note review. For the prospective study, 38 patients with ILO only [63% females, age 57(16) years], 39 patients with asthma only [(56% female, age 53(13) years] and 12 patients with both ILO and asthma [83% female, mean age, 57 (14) years)] completed the BrTS. The triggers identified in the case note review were confirmed in the independent sample of patients with ILO and/or asthma and identified several difference in prevalence of the triggers between disease types. Mechanical factors (talking [P < .001], shouting [P = .007] and swallowing [P = .002]) were more common in the ILO cohort compared to patients with asthma. Environmental factors (pollen/flowers [P = .005] and damp air [P = .012]) were more common in asthma. There were no differences between groups in frequency of reporting scents as triggers (except for vinegar, more common in ILO, P = .019), temperature, emotions or daily activities. There were notable differences between patient-reported triggers of ILO and asthma, which may support clinician differential diagnosis.
Sections du résumé
BACKGROUND
Inducible laryngeal obstruction (ILO) is often misdiagnosed as, or may coexist with, asthma. Identifying differences in triggering factors may assist clinicians to differentiate between the two conditions and could give mechanistic insights.
OBJECTIVE
To identify and compare patient-reported triggers in ILO and asthma.
METHODS
This was a two-part study. Initially, we conducted a retrospective case note review of the triggers of ILO from endoscopically confirmed ILO patients to generate a Breathlessness Triggers Survey (BrTS). Triggers were categorized as scents, environmental factors, temperature, emotions, mechanical factors and daily activities. Secondly, ILO and/or asthma patients completed the BrTS prospectively, rating the likelihood of each item triggering their symptoms using a five-point Likert scale (strongly disagree to strongly agree). Chi-square testing was performed to compare responses by cohort.
RESULTS
Data from 202 patients with ILO [73% female, mean (SD) age 53(16) years] were included in the case note review. For the prospective study, 38 patients with ILO only [63% females, age 57(16) years], 39 patients with asthma only [(56% female, age 53(13) years] and 12 patients with both ILO and asthma [83% female, mean age, 57 (14) years)] completed the BrTS. The triggers identified in the case note review were confirmed in the independent sample of patients with ILO and/or asthma and identified several difference in prevalence of the triggers between disease types. Mechanical factors (talking [P < .001], shouting [P = .007] and swallowing [P = .002]) were more common in the ILO cohort compared to patients with asthma. Environmental factors (pollen/flowers [P = .005] and damp air [P = .012]) were more common in asthma. There were no differences between groups in frequency of reporting scents as triggers (except for vinegar, more common in ILO, P = .019), temperature, emotions or daily activities.
CONCLUSION
There were notable differences between patient-reported triggers of ILO and asthma, which may support clinician differential diagnosis.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1230-1237Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 The Authors. Clinical & Experimental Allergy published by John Wiley & Sons Ltd.
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