Is your asthma diagnosis a false alarm?

33% patients with chronic respiratory condition do not have active, or symptomatic, asthma: study

Chennai, 05-05-2008: A child who is suffering juvinile asthma inhaling a medicinal spray through an aparatus. Photo:S_R_Raghunathan

Research studies suggest that one in three adults diagnosed with chronic respiratory condition — asthma — may not actually have it.

“Asthma can be a very challenging diagnosis to make because all the patients do not necessarily exhibit the same signs and symptoms. Moreover, the hallmark symptoms like difficulty breathing, chest pain, cough and wheezing are vague and mimic other disorders as well. There are many diseases whose symptoms resemble asthma like upper airway obstruction, viral infection, sinus infection, COPD (emphysema or chronic bronchitis), bronchiolitis and pulmonary embolism to name a few,’’ said Dr. K.K. Aggarwal of Indian Medical Association (IMA).

Misuse of medications

The misuse of anti-asthmatic medications by such patients is linked to growth retardation, weakening of immune response and the subsequent high risk of respiratory infections, therefore the situation warrants careful consideration.

It is imperative that physicians remain up-to-date on recent developments in the field of diagnostics and tread with caution before making a final diagnosis, say medical experts.

According to a study published in the Journal of American Medical Association, 33% of people diagnosed with asthma do not have active, or symptomatic, asthma and more than 90% of these patients could do without the prescribed drugs. A recently published study reported that in the Indian setting almost 50% of those who are undergoing treatment for asthma are taking redundant therapeutic interventions. “Use of certain medications like beta blockers can also mimic asthma-like symptoms,’’ said Dr. Aggarwal.

Growing concern

According to a release issued by IMA, this is a growing concern in the medical community because the most worrisome potential harm of misdiagnosis of asthma is not treating the patient’s actual disorder.

The Association has recommended that physicians must make sure that they have the correct diagnosis before embarking on a course of treatment.

“It is in best practice to perform a number of tests to rule out the possibility of other diseases. Differential diagnosis should be the key in this regard and concrete diagnostic tools like spirometry and serial bronchial challenge should remain the gold standard for diagnosing asthma,” the release also said.