Titre
The absence of dyspnoea, cough and wheezing: a reason for undiagnosed airflow obstruction?
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
d'Andiran, G.
Auteure/Auteur
Schindler, C.
Auteure/Auteur
Leuenberger, P.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1424-7860
Statut éditorial
Publié
Date de publication
2006-07-08
Volume
136
Numéro
27-28
Première page
425
Dernière page/numéro d’article
433
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
The diagnosis of obstructive lung disease (OLD) may be overlooked because of the poor correlation between the intensity of symptoms and the severity of airway obstruction (AO). Undiagnosed airflow obstruction (UDAO) is associated with health impairment and mortality. Questions remain such as the reasons for its occurrence and the underlying diseases. In a pulmonologist's private practice, the objectives were to detect UDAO in the absence of dyspnoea, cough and wheezing, to improve its screening following other anamnestic data, and to separate UDAO patients into "silent asthma" (SA) or "persistent obstruction".
Patients were subjected to a verbal questionnaire for the detection of alternative indication for pulmonary function tests (PFTs), to a physical examination and, in the case of a severe smoking habit, to a chest X-ray. PFTs were performed whenever an OLD history or another lung disease was present and, in the absence of any dyspnoea, cough and wheezing, when other symptoms and conditions occurred (sputum, chest tightness, fatigue, rhinitis, snoring; active/passive smoking, recurrent lower respiratory tract infections, asthma in childhood or in family, atopy).
Of 3762 consecutive patients, 1389 patients with AO were identified. Among them, 147 UDAO patients were detected with no history of dyspnoea, cough and wheezing (3.9% and 10.6%, respectively). All these patients had other suggestive symptoms and AO risk factors which justified PFTs. They presented with mild (65%), moderate (21%) or even severe (16%) AO. SA patients normalized their spirometric values under treatment.
The absence of dyspnoea, cough and wheezing is a fairly frequent finding and a reason for UDAO. PFTs are warranted with any suggestive symptoms and AO risk factors. The favourable follow-up underlines the importance of screening for UDAO.
Patients were subjected to a verbal questionnaire for the detection of alternative indication for pulmonary function tests (PFTs), to a physical examination and, in the case of a severe smoking habit, to a chest X-ray. PFTs were performed whenever an OLD history or another lung disease was present and, in the absence of any dyspnoea, cough and wheezing, when other symptoms and conditions occurred (sputum, chest tightness, fatigue, rhinitis, snoring; active/passive smoking, recurrent lower respiratory tract infections, asthma in childhood or in family, atopy).
Of 3762 consecutive patients, 1389 patients with AO were identified. Among them, 147 UDAO patients were detected with no history of dyspnoea, cough and wheezing (3.9% and 10.6%, respectively). All these patients had other suggestive symptoms and AO risk factors which justified PFTs. They presented with mild (65%), moderate (21%) or even severe (16%) AO. SA patients normalized their spirometric values under treatment.
The absence of dyspnoea, cough and wheezing is a fairly frequent finding and a reason for UDAO. PFTs are warranted with any suggestive symptoms and AO risk factors. The favourable follow-up underlines the importance of screening for UDAO.
Sujets
PID Serval
serval:BIB_526BECE0EBBA
PMID
Date de création
2008-01-25T08:50:12.905Z
Date de création dans IRIS
2025-05-20T20:27:42Z
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16862462.pdf
Version du manuscrit
published
Taille
367.51 KB
Format
Adobe PDF
PID Serval
serval:BIB_526BECE0EBBA.P001
URN
urn:nbn:ch:serval-BIB_526BECE0EBBA5
Somme de contrôle
(MD5):93b33d3d41eee2a73f3e7101e5684d1f