The absence of dyspnoea, cough and wheezing: a reason for undiagnosed airflow obstruction?

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State: Public
Version: Final published version
Serval ID
serval:BIB_526BECE0EBBA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The absence of dyspnoea, cough and wheezing: a reason for undiagnosed airflow obstruction?
Journal
Swiss medical weekly
Author(s)
d'Andiran G., Schindler C., Leuenberger P.
ISSN
1424-7860 (Print)
ISSN-L
0036-7672
Publication state
Published
Issued date
08/07/2006
Peer-reviewed
Oui
Volume
136
Number
27-28
Pages
425-433
Language
english
Notes
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Abstract
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.

Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Airway Obstruction/complications, Airway Obstruction/diagnosis, Airway Obstruction/epidemiology, Airway Obstruction/physiopathology, Asthma/complications, Asthma/diagnosis, Cough/etiology, Cough/physiopathology, Dyspnea/etiology, Dyspnea/physiopathology, Female, Follow-Up Studies, Forced Expiratory Volume, Humans, Male, Middle Aged, Prospective Studies, Respiratory Sounds/etiology, Respiratory Sounds/physiopathology, Risk Factors, Severity of Illness Index, Social Class, Surveys and Questionnaires, Switzerland/epidemiology, Vital Capacity
Pubmed
Web of science
Create date
25/01/2008 9:50
Last modification date
20/08/2019 14:07
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