Wheeze differential diagnosis: Difference between revisions

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* Involvement of cartilage of ears, ribs, nose, and eyes
* Involvement of cartilage of ears, ribs, nose, and eyes
|-
|-
| style="background:#DCDCDC;" align="center" + |'''Retropharyngeal abscess'''
| style="background:#DCDCDC;" align="center" + |'''Retropharyngeal abscess'''<ref name="pmid18312875">{{cite journal |vauthors=Page NC, Bauer EM, Lieu JE |title=Clinical features and treatment of retropharyngeal abscess in children |journal=Otolaryngol Head Neck Surg |volume=138 |issue=3 |pages=300–6 |date=March 2008 |pmid=18312875 |doi=10.1016/j.otohns.2007.11.033 |url=}}</ref><ref name="pmid12777558">{{cite journal |vauthors=Craig FW, Schunk JE |title=Retropharyngeal abscess in children: clinical presentation, utility of imaging, and current management |journal=Pediatrics |volume=111 |issue=6 Pt 1 |pages=1394–8 |date=June 2003 |pmid=12777558 |doi= |url=}}</ref><ref name="pmid12479720">{{cite journal |vauthors=Cmejrek RC, Coticchia JM, Arnold JE |title=Presentation, diagnosis, and management of deep-neck abscesses in infants |journal=Arch. Otolaryngol. Head Neck Surg. |volume=128 |issue=12 |pages=1361–4 |date=December 2002 |pmid=12479720 |doi= |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Subacute
| style="background:#F5F5F5;" align="center" + |Subacute
| style="background:#F5F5F5;" align="center" + |<nowiki>-</nowiki>
| style="background:#F5F5F5;" align="center" + |<nowiki>-</nowiki>
Line 337: Line 337:
* Head in sniffing position
* Head in sniffing position
|-
|-
| style="background:#DCDCDC;" align="center" + |'''Tonsillar hypertrophy'''
| style="background:#DCDCDC;" align="center" + |'''Tonsillar hypertrophy'''<ref name="pmid20131382">{{cite journal |vauthors=Kaditis AG, Kalampouka E, Hatzinikolaou S, Lianou L, Papaefthimiou M, Gartagani-Panagiotopoulou P, Zintzaras E, Chrousos G |title=Associations of tonsillar hypertrophy and snoring with history of wheezing in childhood |journal=Pediatr. Pulmonol. |volume=45 |issue=3 |pages=275–80 |date=March 2010 |pmid=20131382 |doi=10.1002/ppul.21174 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Acute, chronic
| style="background:#F5F5F5;" align="center" + |Acute, chronic
| style="background:#F5F5F5;" align="center" + |<nowiki>-</nowiki>
| style="background:#F5F5F5;" align="center" + |<nowiki>-</nowiki>
Line 360: Line 360:
* More in children and adolescents
* More in children and adolescents
|-
|-
| style="background:#DCDCDC;" align="center" + |'''Tumor of pharynx/larynx/upper trachea'''
| style="background:#DCDCDC;" align="center" + |'''Tumor of pharynx/larynx/upper trachea'''<ref name="pmid23328541">{{cite journal |vauthors=Bradley PT, Bradley PJ |title=Branchial cleft cyst carcinoma: fact or fiction? |journal=Curr Opin Otolaryngol Head Neck Surg |volume=21 |issue=2 |pages=118–23 |date=April 2013 |pmid=23328541 |doi=10.1097/MOO.0b013e32835cebde |url=}}</ref><ref name="pmid6537892">{{cite journal |vauthors=Silverman S, Gorsky M, Lozada F |title=Oral leukoplakia and malignant transformation. A follow-up study of 257 patients |journal=Cancer |volume=53 |issue=3 |pages=563–8 |date=February 1984 |pmid=6537892 |doi= |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Chronic
| style="background:#F5F5F5;" align="center" + |Chronic
| style="background:#F5F5F5;" align="center" + |✔
| style="background:#F5F5F5;" align="center" + |✔
Line 387: Line 387:
| rowspan="6" style="background:#DCDCDC;" align="center" + |'''Central airway diseases'''
| rowspan="6" style="background:#DCDCDC;" align="center" + |'''Central airway diseases'''
'''(Intrathoracic upper airway obstruction)'''
'''(Intrathoracic upper airway obstruction)'''
| style="background:#DCDCDC;" align="center" + |'''Mediastinal mass/lymphadenopathy'''
| style="background:#DCDCDC;" align="center" + |'''Mediastinal mass/lymphadenopathy'''<ref name="pmid22173664">{{cite journal |vauthors=Kawahara K, Miyawaki M, Anami K, Moroga T, Yamamoto S, Tokuishi K, Yamashita S, Kumamoto T |title=A patient with mediastinal mature teratoma presenting with paraneoplastic limbic encephalitis |journal=J Thorac Oncol |volume=7 |issue=1 |pages=258–9 |date=January 2012 |pmid=22173664 |doi=10.1097/JTO.0b013e318236eade |url=}}</ref><ref name="pmid20975383">{{cite journal |vauthors=Stover DG, Eisenberg R, Johnson DH |title=Anti-N-methyl-D-aspartate receptor encephalitis in a young woman with a mature mediastinal teratoma |journal=J Thorac Oncol |volume=5 |issue=11 |pages=1872–3 |date=November 2010 |pmid=20975383 |doi=10.1097/JTO.0b013e3181eba81d |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Chronic
| style="background:#F5F5F5;" align="center" + |Chronic
| style="background:#F5F5F5;" align="center" + |✔
| style="background:#F5F5F5;" align="center" + |✔
Line 416: Line 416:
* [[Surgical resection]]  
* [[Surgical resection]]  
|-
|-
| style="background:#DCDCDC;" align="center" + |'''Respiratory papillomatosis'''
| style="background:#DCDCDC;" align="center" + |'''Respiratory papillomatosis'''<ref name="pmid18496162">{{cite journal |vauthors=Derkay CS, Wiatrak B |title=Recurrent respiratory papillomatosis: a review |journal=Laryngoscope |volume=118 |issue=7 |pages=1236–47 |date=July 2008 |pmid=18496162 |doi=10.1097/MLG.0b013e31816a7135 |url=}}</ref><ref name="pmid23013073">{{cite journal |vauthors=Yuan H, Myers S, Wang J, Zhou D, Woo JA, Kallakury B, Ju A, Bazylewicz M, Carter YM, Albanese C, Grant N, Shad A, Dritschilo A, Liu X, Schlegel R |title=Use of reprogrammed cells to identify therapy for respiratory papillomatosis |journal=N. Engl. J. Med. |volume=367 |issue=13 |pages=1220–7 |date=September 2012 |pmid=23013073 |pmc=4030597 |doi=10.1056/NEJMoa1203055 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Chronic
| style="background:#F5F5F5;" align="center" + |Chronic
| style="background:#F5F5F5;" align="center" + |✔
| style="background:#F5F5F5;" align="center" + |✔
Line 441: Line 441:
* [[Biopsy]] to determine the type of virus
* [[Biopsy]] to determine the type of virus
|-
|-
| style="background:#DCDCDC;" align="center" + |'''Tracheobronchomalacia'''
| style="background:#DCDCDC;" align="center" + |'''Tracheobronchomalacia'''<ref name="pmid16771908">{{cite journal |vauthors=Murgu SD, Colt HG |title=Tracheobronchomalacia and excessive dynamic airway collapse |journal=Respirology |volume=11 |issue=4 |pages=388–406 |date=July 2006 |pmid=16771908 |doi=10.1111/j.1440-1843.2006.00862.x |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Chronic
| style="background:#F5F5F5;" align="center" + |Chronic
| style="background:#F5F5F5;" align="center" + |✔
| style="background:#F5F5F5;" align="center" + |✔
Line 466: Line 466:
* [[Barking cough]]  
* [[Barking cough]]  
|-
|-
| style="background:#DCDCDC;" align="center" + |'''Tracheal stenosis'''
| style="background:#DCDCDC;" align="center" + |'''Tracheal stenosis'''<ref name="pmid15187010">{{cite journal |vauthors=Ernst A, Feller-Kopman D, Becker HD, Mehta AC |title=Central airway obstruction |journal=Am. J. Respir. Crit. Care Med. |volume=169 |issue=12 |pages=1278–97 |date=June 2004 |pmid=15187010 |doi=10.1164/rccm.200210-1181SO |url=}}</ref><ref name="pmid11866017">{{cite journal |vauthors=Bolliger CT, Mathur PN, Beamis JF, Becker HD, Cavaliere S, Colt H, Diaz-Jimenez JP, Dumon JF, Edell E, Kovitz KL, Macha HN, Mehta AC, Marel M, Noppen M, Strausz J, Sutedja TG |title=ERS/ATS statement on interventional pulmonology. European Respiratory Society/American Thoracic Society |journal=Eur. Respir. J. |volume=19 |issue=2 |pages=356–73 |date=February 2002 |pmid=11866017 |doi= |url=}}</ref><ref name="pmid12740291">{{cite journal |vauthors=Ernst A, Silvestri GA, Johnstone D |title=Interventional pulmonary procedures: Guidelines from the American College of Chest Physicians |journal=Chest |volume=123 |issue=5 |pages=1693–717 |date=May 2003 |pmid=12740291 |doi= |url=}}</ref><ref name="pmid10649204">{{cite journal |vauthors=Stephens KE, Wood DE |title=Bronchoscopic management of central airway obstruction |journal=J. Thorac. Cardiovasc. Surg. |volume=119 |issue=2 |pages=289–96 |date=February 2000 |pmid=10649204 |doi=10.1016/S0022-5223(00)70184-X |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Acute
| style="background:#F5F5F5;" align="center" + |Acute
| style="background:#F5F5F5;" align="center" + | -
| style="background:#F5F5F5;" align="center" + | -
Line 490: Line 490:
* Long segment stenosis incompatible with survival<ref name="pmid16481247">{{cite journal |vauthors=Chiu PP, Rusan M, Williams WG, Caldarone CA, Kim PC |title=Long-term outcomes of clinically significant vascular rings associated with congenital tracheal stenosis |journal=J. Pediatr. Surg. |volume=41 |issue=2 |pages=335–41 |date=February 2006 |pmid=16481247 |doi=10.1016/j.jpedsurg.2005.11.034 |url=}}</ref>
* Long segment stenosis incompatible with survival<ref name="pmid16481247">{{cite journal |vauthors=Chiu PP, Rusan M, Williams WG, Caldarone CA, Kim PC |title=Long-term outcomes of clinically significant vascular rings associated with congenital tracheal stenosis |journal=J. Pediatr. Surg. |volume=41 |issue=2 |pages=335–41 |date=February 2006 |pmid=16481247 |doi=10.1016/j.jpedsurg.2005.11.034 |url=}}</ref>
|-
|-
| style="background:#DCDCDC;" align="center" + |'''Tracheal and bronchial tumors'''
| style="background:#DCDCDC;" align="center" + |'''Tracheal and bronchial tumors'''<ref name="pmid24295654">{{cite journal |vauthors=Brand-Saberi BE, Schäfer T |title=Trachea: anatomy and physiology |journal=Thorac Surg Clin |volume=24 |issue=1 |pages=1–5 |date=February 2014 |pmid=24295654 |doi=10.1016/j.thorsurg.2013.09.004 |url=}}</ref><ref name="pmid25978628">{{cite journal |vauthors=Sherani K, Vakil A, Dodhia C, Fein A |title=Malignant tracheal tumors: a review of current diagnostic and management strategies |journal=Curr Opin Pulm Med |volume=21 |issue=4 |pages=322–6 |date=July 2015 |pmid=25978628 |doi=10.1097/MCP.0000000000000181 |url=}}</ref><ref name="pmid24034267">{{cite journal |vauthors=Wu CC, Shepard JA |title=Tracheal and airway neoplasms |journal=Semin Roentgenol |volume=48 |issue=4 |pages=354–64 |date=October 2013 |pmid=24034267 |doi=10.1053/j.ro.2013.03.018 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Chronic  
| style="background:#F5F5F5;" align="center" + |Chronic  
| style="background:#F5F5F5;" align="center" + |✔
| style="background:#F5F5F5;" align="center" + |✔
Line 515: Line 515:
* [[Benign tumors]]
* [[Benign tumors]]
|-
|-
| style="background:#DCDCDC;" align="center" + |'''Vascular ring or aneurysm'''
| style="background:#DCDCDC;" align="center" + |'''Vascular ring or aneurysm'''<ref name="pmid25604054">{{cite journal |vauthors=Licari A, Manca E, Rispoli GA, Mannarino S, Pelizzo G, Marseglia GL |title=Congenital vascular rings: a clinical challenge for the pediatrician |journal=Pediatr. Pulmonol. |volume=50 |issue=5 |pages=511–24 |date=May 2015 |pmid=25604054 |doi=10.1002/ppul.23152 |url=}}</ref><ref name="pmid17034866">{{cite journal |vauthors=Shah RK, Mora BN, Bacha E, Sena LM, Buonomo C, Del Nido P, Rahbar R |title=The presentation and management of vascular rings: an otolaryngology perspective |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=71 |issue=1 |pages=57–62 |date=January 2007 |pmid=17034866 |doi=10.1016/j.ijporl.2006.08.025 |url=}}</ref><ref name="pmid16585275">{{cite journal |vauthors=Humphrey C, Duncan K, Fletcher S |title=Decade of experience with vascular rings at a single institution |journal=Pediatrics |volume=117 |issue=5 |pages=e903–8 |date=May 2006 |pmid=16585275 |doi=10.1542/peds.2005-1674 |url=}}</ref><ref name="pmid11515879">{{cite journal |vauthors=Woods RK, Sharp RJ, Holcomb GW, Snyder CL, Lofland GK, Ashcraft KW, Holder TM |title=Vascular anomalies and tracheoesophageal compression: a single institution's 25-year experience |journal=Ann. Thorac. Surg. |volume=72 |issue=2 |pages=434–8; discussion 438–9 |date=August 2001 |pmid=11515879 |doi= |url=}}</ref><ref name="pmid15942575">{{cite journal |vauthors=Backer CL, Mavroudis C, Rigsby CK, Holinger LD |title=Trends in vascular ring surgery |journal=J. Thorac. Cardiovasc. Surg. |volume=129 |issue=6 |pages=1339–47 |date=June 2005 |pmid=15942575 |doi=10.1016/j.jtcvs.2004.10.044 |url=}}</ref><ref name="pmid15666159">{{cite journal |vauthors=Turner A, Gavel G, Coutts J |title=Vascular rings--presentation, investigation and outcome |journal=Eur. J. Pediatr. |volume=164 |issue=5 |pages=266–70 |date=May 2005 |pmid=15666159 |doi=10.1007/s00431-004-1607-6 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Chronic
| style="background:#F5F5F5;" align="center" + |Chronic
| style="background:#F5F5F5;" align="center" + |✔
| style="background:#F5F5F5;" align="center" + |✔
Line 544: Line 544:
|-
|-
| rowspan="9" style="background:#DCDCDC;" align="center" + |Lower airway obstruction
| rowspan="9" style="background:#DCDCDC;" align="center" + |Lower airway obstruction
| style="background:#DCDCDC;" align="center" + |'''Bronchiectasis'''
| style="background:#DCDCDC;" align="center" + |'''Bronchiectasis'''<ref name="pmid16650970">{{cite journal |vauthors=King PT, Holdsworth SR, Freezer NJ, Villanueva E, Holmes PW |title=Characterisation of the onset and presenting clinical features of adult bronchiectasis |journal=Respir Med |volume=100 |issue=12 |pages=2183–9 |date=December 2006 |pmid=16650970 |doi=10.1016/j.rmed.2006.03.012 |url=}}</ref><ref name="pmid20627931">{{cite journal |vauthors=Pasteur MC, Bilton D, Hill AT |title=British Thoracic Society guideline for non-CF bronchiectasis |journal=Thorax |volume=65 Suppl 1 |issue= |pages=i1–58 |date=July 2010 |pmid=20627931 |doi=10.1136/thx.2010.136119 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Chronic
| style="background:#F5F5F5;" align="center" + |Chronic
| style="background:#F5F5F5;" align="center" + |✔
| style="background:#F5F5F5;" align="center" + |✔
Line 574: Line 574:
* Chest [[pleuritic pain]]
* Chest [[pleuritic pain]]
|-
|-
| style="background:#DCDCDC;" align="center" + |'''Bronchiolitis'''
| style="background:#DCDCDC;" align="center" + |'''Bronchiolitis'''<ref name="pmid11512084">{{cite journal |vauthors=Hall CB, Long CE, Schnabel KC |title=Respiratory syncytial virus infections in previously healthy working adults |journal=Clin. Infect. Dis. |volume=33 |issue=6 |pages=792–6 |date=September 2001 |pmid=11512084 |doi=10.1086/322657 |url=}}</ref><ref name="pmid3706232">{{cite journal |vauthors=Glezen WP, Taber LH, Frank AL, Kasel JA |title=Risk of primary infection and reinfection with respiratory syncytial virus |journal=Am. J. Dis. Child. |volume=140 |issue=6 |pages=543–6 |date=June 1986 |pmid=3706232 |doi= |url=}}</ref><ref name="pmid10885982">{{cite journal |vauthors=Falsey AR, Walsh EE |title=Respiratory syncytial virus infection in adults |journal=Clin. Microbiol. Rev. |volume=13 |issue=3 |pages=371–84 |date=July 2000 |pmid=10885982 |pmc=88938 |doi= |url=}}</ref><ref name="pmid16007526">{{cite journal |vauthors=O'Shea MK, Ryan MA, Hawksworth AW, Alsip BJ, Gray GC |title=Symptomatic respiratory syncytial virus infection in previously healthy young adults living in a crowded military environment |journal=Clin. Infect. Dis. |volume=41 |issue=3 |pages=311–7 |date=August 2005 |pmid=16007526 |doi=10.1086/431591 |url=}}</ref><ref name="pmid7836643">{{cite journal |vauthors=Wald TG, Miller BA, Shult P, Drinka P, Langer L, Gravenstein S |title=Can respiratory syncytial virus and influenza A be distinguished clinically in institutionalized older persons? |journal=J Am Geriatr Soc |volume=43 |issue=2 |pages=170–4 |date=February 1995 |pmid=7836643 |doi= |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Acute
| style="background:#F5F5F5;" align="center" + |Acute
| style="background:#F5F5F5;" align="center" + |✔
| style="background:#F5F5F5;" align="center" + |✔

Revision as of 21:55, 6 March 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Karina Zavaleta, MD [2]

Differential diagnosis of Wheezing

Etiology on the basis of anatomy Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam Labs Pulmonary function testing Imaging
Onset Cough Dyspnea Fever Slurred speech Cyanosis Clubbing Auscultation Chest imaging Other Gold standard
Extrathoracic upper airway diseases Laryngeal edema

(Anaphylaxis)[1][2][3][4][5]

Acute - - -
  • Not specific
  • Not required
  • Not required

Acute onset with one of them:

Two or more after the exposure to a likely allergen

BP reduced after exposure of a known allergen

Cricoarytenoid arthritis[6][7] Acute - - -
  • Clear chest
Vocal fold edema/hematoma/paralysis[9] Acute - - -
  • Not specific
  • Variable
  • Clear chest
  • Not required
Paradoxical vocal fold motion[10][11] Acute - - -
  • Clear chest
  • CT and color flow doppler to rule out other diseases[13]
Laryngeal stenosis[15] Acute, Chronic - -
  • Not specific
  • FV loop variable
  • Clear chest
Laryngocele[17][18][19][20][21] Chronic - - - -
  • Not specific
  • Normal function
  • Clear chest
Epiglottitis (supraglottitis)[22][23][24][25][26] Acute - - -
  • Normal function
  • Clear chest
  • Tripod posture
  • Drooling
  • Tenderness of the anterior part of the neck
Goiter[27][28][29][30][31][32][33][34] Chronic - - - -
  • Airflow limitation of the volume loop depending on the size and localization[35]
Postnasal drip syndrome[38][39][40] Acute - - - -
  • Increase of IgE
  • Positive intradermic test[41]
  • Clear chest
  • Sinus CT may be helpful
  • Clinical diagnosis
Relapsing polychondritis [42][43][44][45][46][47][48] Acute - - -
  • Variable flow volume loop
  • Tracheal narrowing
  • Cartilaginous calcification, bronchial wall thickness, and tracheal narrowing is observed on CT 
  • MRI can distinguish fibrosis from inflammation 

Mc Adam criteria:[47]

  • Involvement of cartilage of ears, ribs, nose, and eyes
Retropharyngeal abscess[50][51][52] Subacute - - -
  • Normal function
  • Neck CT or presence of pus during the surgical procedure[54]
Tonsillar hypertrophy[55] Acute, chronic - - ✔ hyponasal speech - -
  • Not specific
  • Flow loop shows inspiratory slowing
  • Clear chest
  • Not required
  • More in children and adolescents
Tumor of pharynx/larynx/upper trachea[57][58] Chronic - - - -
  • Not specific
  • Flow loop shows inspiratory slowing
  • Not required
  • CT provide information about the grade of invasion
  • MRI can make a difference between tumors in the mucosa or bone marrow[59]
Central airway diseases

(Intrathoracic upper airway obstruction)

Mediastinal mass/lymphadenopathy[60][61] Chronic - - -
  • Size, location, and density of the mass can be observed
  • In chest CT, location, size, tissue characteristic, and relationship with other structures of the mass is observed
  • Information of posterior mediastinal mass can be provided in chest or spine MRI [63]
Respiratory papillomatosis[64][65] Chronic - - -
  • Not specific
  • Not specific
Tracheobronchomalacia[67] Chronic - - - -
  • Not specifc
  • Airway compression from other structures
Tracheal stenosis[70][71][72][73] Acute - - - -
  • Not specific
  • FV loop variable
  • Extension of the narrowing observed in CT or MRI
  • Long segment stenosis incompatible with survival[75]
Tracheal and bronchial tumors[76][77][78] Chronic - - - -
  • Not specific
  • FV loop variable
Vascular ring or aneurysm[80][81][82][83][84][85] Chronic - - - -
  • Not required
  • Usually asymptomatic
  • Chest or abdominal pain appears when other structures are compressed
Lower airway obstruction Bronchiectasis[87][88] Chronic - - -
  • Tram lines or end-on ring shadows in chest CT [90]
Bronchiolitis[91][92][93][94][95] Acute - - For bacterial infection in neonates:
  • Hyperinflation
  • Mosaic attenuation
  • Increased bronchial wall[96]
  • Clinical diagnosis
Carcinoid syndrome Chronic - - - - -
  • Not specific
  • Liver metastases are visualized in MRI
Heart failure Chronic - - - -
  • Not required
  • Clinical diagnosis (test are supportive)
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) [102] Chronic - - - -
  • Not specific
  • Mosaic pattern and nodules observed in chest CT
  • Single neuroendocrine cell and/ or linear proliferation of the cells that involves bronchial epithelium
Noncardiogenic pulmonary edema Acute - - -
  • Bilateral alveolar infiltration
  • Bilateral opacities in CT

According to Berlin definition:[103]

  • One week of new or worse respiratory symptoms or clinical insult
  • Symptoms can not be explain by cardiac disease
  • Bilateral opacities in chest X-Ray or CT
  • Compromised oxygenation
  • High altitute pulmonary edema (HAPE)
  • Neurogenic pulmonary edema
Parasitic infection with VLM (eg, Ascaris, Strongyloides, filaria) Acute - - -
  • Not specific
  • Bilateral peribronchial infiltration
  • Parenchymal infiltration
  • Subpleural nodules, ground-glass opacities observed on chest CT [105]
  • Larve on biopsy
Pulmonary thromboembolism  Acute, subacute, Chronic - - - -
  • Not required
Reactive airways dysfunction syndrome Acute - - - -
  • Normal or hyperinflation
  • CT to rule out other diseases
Clinical diagnosis:
  • History of exposure
  • Acute onset with sympotoms in 24h
  • Airway obstruction > 3 months[109]
  • Burning sensation in the throat
  • Chest pain
  • High dose of inhalation of the irritant

References

  1. Sampson HA, Muñoz-Furlong A, Campbell RL, Adkinson NF, Bock SA, Branum A, Brown SG, Camargo CA, Cydulka R, Galli SJ, Gidudu J, Gruchalla RS, Harlor AD, Hepner DL, Lewis LM, Lieberman PL, Metcalfe DD, O'Connor R, Muraro A, Rudman A, Schmitt C, Scherrer D, Simons FE, Thomas S, Wood JP, Decker WW (February 2006). "Second symposium on the definition and management of anaphylaxis: summary report--Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium". J. Allergy Clin. Immunol. 117 (2): 391–7. doi:10.1016/j.jaci.2005.12.1303. PMID 16461139.
  2. Sampson HA, Muñoz-Furlong A, Bock SA, Schmitt C, Bass R, Chowdhury BA, Decker WW, Furlong TJ, Galli SJ, Golden DB, Gruchalla RS, Harlor AD, Hepner DL, Howarth M, Kaplan AP, Levy JH, Lewis LM, Lieberman PL, Metcalfe DD, Murphy R, Pollart SM, Pumphrey RS, Rosenwasser LJ, Simons FE, Wood JP, Camargo CA (March 2005). "Symposium on the definition and management of anaphylaxis: summary report". J. Allergy Clin. Immunol. 115 (3): 584–91. doi:10.1016/j.jaci.2005.01.009. PMID 15753908.
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