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Recalcitrant asthma: an allergist's approach.

A T Luskin1

  • 1Department of Immunology/Microbiology, Rush Medical Center, Chicago, IL 60612.

Allergy Proceedings : the Official Journal of Regional and State Allergy Societies
|November 1, 1990
PubMed
Summary
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Recalcitrant asthma, uncontrolled asthma requiring steroids, can be managed by systematically evaluating triggers and coexisting conditions. This approach improves patient quality of life.

Area of Science:

  • Pulmonology
  • Allergy and Immunology

Background:

  • Recalcitrant asthma is defined as asthma with incomplete symptom control or need for systemic steroids.
  • Identifying and managing contributing factors is crucial for improving patient outcomes.

Purpose of the Study:

  • To present a systematic approach for evaluating patients with recalcitrant asthma.
  • To identify common and rare conditions that mimic or exacerbate asthma.

Main Methods:

  • Review of factors contributing to uncontrolled asthma.
  • Evaluation of differential diagnoses for persistent respiratory symptoms.

Main Results:

  • Key factors include environmental antigens, occupational exposures, medications (beta-blockers, NSAIDs), dietary sensitivities, endocrinopathies, gastroesophageal reflux, sinusitis, and bronchopulmonary aspergillosis.

Related Experiment Videos

  • Differential diagnoses include congestive heart failure, cystic fibrosis, ciliary dysfunction, immunodeficiency, upper airway obstruction, pertussis, psychogenic cough, bronchiolitis obliterans, chronic eosinophilic pneumonia, and vasculitis.

    • Conclusions:

    • A systematic evaluation of coexisting factors and alternative diagnoses is essential for managing recalcitrant asthma.
    • This comprehensive approach can significantly enhance the quality of life for patients with difficult-to-control asthma.