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Progress in Distinguishing Asthma from COPD

February 25, 2011

FEATURED SEARCH:  asthma

You've known for a long time that it can be difficult to distinguish asthma from COPD in older patients. Recent research is improving on ways to tell them apart in diagnosis. In this report, a team from Saudi Arabia took a hard look at smokers who fulfill the criteria for COPD, and found that many of them actually had asthma. You can tell the difference, they propose, by watching how forced expiratory volume fluctuates over the course of a year.

RESULT:  Asthma Masquerading as Chronic Obstructive Pulmonary Disease: A Study of Smokers Fulfilling the GOLD Definition of Chronic Obstructive Pulmonary Disease
Respiration | Jan 29, 2011 (Free abstract. Full text $38)

Genes that affect lung development in utero, combined with different environmental factors encountered during early life and later (allergens, infection, smoking) may explain why some people develop asthma and others COPD (while still others stay healthy). The authors of this review suggest that personalized medicine will ultimately help to predict who is vulnerable to which disease.

RESULT:  Asthma and COPD: Common Genes, Common Environments?
American Journal of Respiratory & Critical Care Medicine | Feb 4, 2011 (Free abstract. Full text $10)

It's crucial for primary care teams to distinguish the two disorders, say the authors of this modestly priced review, because the treatment of COPD is so different from that of asthma. Often COPD is misdiagnosed until relatively late in the course of the disease, they add. The title of the review mentions only COPD, but the text recommends questionnaires and imaging studies that can differentiate it from asthma. 

RESULT:  Improving the differential diagnosis of COPD in primary care
Mayo Clinic Proceedings (PubMed) | Dec 1, 2010 (Free abstract. Full text $11)

Researchers in the Netherlands have developed a protocol for deciding which pulmonary function tests to use in distinguishing asthma from COPD, and then tested it in a randomized trial against letting lung specialists decide on their own which tests to try. Patients treated by doctors in the control group had more visits and more tests before the correct diagnosis was reached. The protocol itself is reproduced in this open-access document. 

RESULT: The optimization of the diagnostic work-up in patients with suspected obstructive lung disease
BMC Pulmonary Medicine | Nov 23, 2010 (FREE FULL TEXT)

 

 

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