Diagnostic pitfalls in asthma.

ABSTRACT

Asthma is a common disease, diagnosed and treated routinely, that still lacks a clear, universally accepted definition. The diagnosis, made mostly by history and physical diagnosis, is often supported by peak flow rate or spirometric measurements. This time-honored approach may prove to be unreliable, resulting in overdiagnosis of the disease. The literature is replete with reports about patients treated as if they had asthma in whom other pulmonary diseases were eventually diagnosed. The incidence of asthma is increasing; there seems to be a lower threshold now for making this diagnosis. Overdiagnosis can be avoided, however, by systematic evaluation and complete pulmonary function testing. This paper presents two examples of clinical carelessness resulting in diagnostic delay of underlying disorders mimicking bronchial asthma.