Adult Asthma Misdiagnosed by One-Third?


Are you an adult with asthma?

Maybe not.

In an interesting twist, while asthma is generally under diagnosed in children, up to 30% of asthma diagnoses in adults may be incorrect.

Most of you probably know firsthand the long, slow process of getting an asthma diagnosis for a child. Like me, you likely dragged your kid to the doctor and ER over and over again, wondering why she kept getting sick and staying sick all the time, why she couldn’t stop coughing, why every cold dragged on for weeks at a time, and when you’d ever get to sleep soundly through the night again. Babies, toddlers, and little kids are less than clear about what’s going on inside their bodies and except for wheezing, the symptoms of recurring flares in children look remarkably similar to the symptoms of severe colds, and the little germ factories get those all the time, anyway.

But in adults, the lingering effects of major viral infections, COPD, and even congestive heart failure can all mimic asthma. Which may explain why Canadian researchers recently discovered no evidence of asthma in one-third of 496 previously diagnosed study participants after performing lung function tests and stopping medication. Those misdiagnoses are a big deal, when you consider both A) the high cost of asthma maintenance and rescue meds and B) what can happen to these (apparently) non-asthmatics if they actually suffer from another serious condition that doctors aren’t treating.

That’s why the study authors stress the need for more doctors to perform spirometry lung function tests before diagnosing asthma. (For a definition of spirometry, check out my alphabetical Glossary.)

This is a good lesson for all of us, really. Because some researchers and medical folks now suggest asthma is more a syndrome or collection of syndromes than a disease, with a whole slew of causes and symptoms. No matter what we call it, though, the one feature that distinguishes between an asthma-like illness and the actual, chronic lifelong condition is reduced lung function. Asthmatics just don’t move air in and out of their lungs as well as they should.

Somewhat limited lung function explains why, even though her health is worlds better now than when she was younger, AG has that tight, dry cough right now in addition to the symptoms of her current cold. It’s what woke me up in the middle of the night to bring her the rescue inhaler yesterday. It’s how she gets that lingering cough during and after respiratory illnesses, every single time, and how she always has a worse time than her non-asthmatic sister during colds and viruses.

And that one feature, those spazzy lungs that just don’t perform as well even during the absence of outward symptoms, is measured through spirometry.

Have you had lung function tests? Has your kid?

90 responses to “Adult Asthma Misdiagnosed by One-Third?”

  1. freadom says:

    Again, great wisdom. My turn to ask you a Q.

    Have you ever come across any articles that stated exactly WHEN the theory that asthma was psychosomatic was disproven? Studies?

  2. Noelle says:

    I’m still waiting to get my health insurance back so I can go to the allergist and figure out why my lung capacity has been on the fritz lately.

  3. wendy says:

    I can believe asthma is a syndrome (or collection of syptoms) rather than a solitary illness. I think it is far more complex than we know.

    My children had a mild form of asthma in childhood. One was exercise induced and the other was more seasonal allergens. Coughs, colds that lingered, but no inhalors. No attacks that sent us to the hospital, so we were lucky. As adults they have outgrown their asthma.

    So no lung function studies. Hubby, however, with his COPD has had numerous spirometry tests. His last one he couldn’t do, so go figure…. Not much lung function left.

  4. Steve says:

    I often wondered about that myself. It’s a very thin line between chronic asthma and copd… Great article!

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