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Adult-onset asthma
1AM, MBBS, MD, M Hlth and Med Law, FRACP, FCCP, FACLM, FAICD, Consultant Respiratory Physician, Mercy Private Hospital, East Melbourne, VIC; Chairman, National Asthma Council Australia, South Melbourne, VIC.
Australian Family Physician
|October 29, 2015
Summary
Adult-onset asthma is often misdiagnosed and differs from childhood asthma. Diagnosis requires confirming reversible airflow obstruction, distinguishing it from COPD, and establishing management goals.
Area of Science:
- Pulmonology
- Allergy and Immunology
Background:
- Adult-onset asthma is frequently overlooked or misdiagnosed.
- It presents differently from childhood asthma, often being less controlled and linked to a faster lung function decline.
- Key risk factors include environmental exposures, obesity, rhinitis, and psychological stress.
Purpose of the Study:
- To provide a comprehensive overview of adult-onset asthma.
Main Methods:
- Clinical presentation analysis.
- Differential diagnosis considerations (e.g., COPD).
- Diagnostic confirmation via spirometry and provocation testing.
Main Results:
- Adult-onset asthma shares clinical similarities with asthma in other age groups.
- Diagnosis confirmation relies on demonstrating reversible airflow obstruction (e.g., >200 ml or 12% increase in FEV1 post-bronchodilator) or a positive provocation test.
- Careful differentiation from conditions like COPD is crucial.
Conclusions:
- Accurate diagnosis of adult-onset asthma is essential.
- Management involves confirming the diagnosis, assessing symptom control, patient education, and setting treatment objectives.
- Distinguishing adult-onset asthma from COPD and other conditions with overlapping symptoms is critical.
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