Some Kids Are Being Misdiagnosed With Asthma, Study Finds

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Some Kids Are Being Misdiagnosed With Asthma, Study Finds

http://www.sciencedaily.com/releases/2007/08/070830160759.htm

Science Daily — More than 6 million kids in this country have

asthma -- or do they? New research shows many children are being

misdiagnosed. Instead of asthma, they may actually have Vocal Chord

Dysfunction, a much less serious condition that doesn't require

medication. A simple test can show doctors and parents the

difference between asthma and VCD.

Vocal cord dysfunction (VCD) is the sudden, abnormal narrowing of

the vocal cords during inhalation causing obstruction of the

airflow, and is characterized by a noise that can mimic the sound of

wheezing. A VCD attack can easily be mistaken for an asthma attack

though it does not respond to asthma medications.

Treatment of VCD relies on correct identification of the disorder

using breathing and relaxation techniques to help the vocal cords

relax. During an acute VCD attack, spirometry (a device that

measures airflows) can show patterns that are highly suggestive of

VCD.

Doctors at Columbus Children's Hospital performed a clinical

research study using spirometry in Children's Emergency Department

to try to identify adolescents who had findings suggestive of VCD

compared to an acute asthma attack. The year-long study (February

2005-February 2006) included patients 12-21-years-old who suffered

from acute episodes of respiratory distress.

" Both asthma and VCD are very common, and emergency departments

across the country are seeing more and more kids with these kinds of

symptoms, " said McCoy, MD, chief of Pulmonology at Columbus

Children's Hospital and a faculty member at The Ohio State

University College of Medicine. " While they may appear similar to

parents, the conditions act differently and must be treated

differently. It is important that parents, coaches and family

doctors are aware of the differences. "

According to the study, 12 of the 17 adolescents who presented to

the Emergency Department with difficulty breathing, but with high

normal oxygen levels, were found to have evidence of VCD on

spirometry. This led to a change in the therapy for these patients.

Spirometry used in the acute setting of difficulty breathing can

help differentiate VCD from asthma attacks.

" Our study suggests that if more emergency departments made use of

the spirometry test, it could cut down on the number of kids who are

misdiagnosed and potentially hospitalized, " said Muffy Chrysler BS,

RRT, NPS, AE, a co-author on the study and an asthma coordinator in

Respiratory Care at Columbus Children's Hospital.

The research was published in the July issue of Pediatric

Pulmonology.

Nolan, MD, FAAP, the study's lead author, was a fellow at

Columbus Children's Hospital while working on this manuscript.

Nolan, a pediatric pulmonologist, is now with Texas Tech University

Health Sciences Center and is a faculty member in the Department of

Pediatrics at Texas Tech.