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[A case variant asthma with acetylcholine inhalation challenge test]
1Department of Allergy and Respiratory Disease, Doai Memorial Hospital, Tokyo, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi
|May 1, 1994
Summary
Exertional dyspnea can indicate bronchial asthma, even with normal initial tests. Acetylcholine inhalation challenge tests and bronchodilators are key for diagnosing and treating this variant asthma.
Area of Science:
- Pulmonology
- Respiratory Medicine
Background:
- Exertional dyspnea is a common respiratory complaint.
- Bronchial asthma can present atypically, posing diagnostic challenges.
Observation:
- A 55-year-old male presented with exertional dyspnea and a family history of asthma.
- Initial evaluations including physical exam, pulmonary function tests, and imaging were unremarkable.
- The patient exhibited hyperresponsiveness to an acetylcholine inhalation challenge test.
Findings:
- The acetylcholine inhalation challenge test revealed a respiratory threshold of 625 micrograms/ml, suggesting airway hyperreactivity.
- A variant form of bronchial asthma was diagnosed based on the positive challenge test.
- Administration of a bronchodilator led to complete symptom resolution.
Implications:
- Exertional dyspnea as an isolated symptom warrants consideration of bronchial asthma.
- The acetylcholine inhalation challenge test is a valuable diagnostic tool for variant asthma.
- Early diagnosis and treatment with bronchodilators can effectively manage exertional dyspnea in asthma patients.