Basic diagnostic approach to suspected allergic asthma

• Published in: MMW Fortschritte der Medizin 2007-02, Vol.149 (7), p.36
• Main Authors: Roesner, D, Virchow, J C
• Format: Article
• Language: ger
• Subjects: Adult; Airway Obstruction - diagnosis; Asthma - diagnosis; Bronchial Provocation Tests; Bronchial Spasm - diagnosis; Child; Decision Trees; Diagnosis, Differential; Dyspnea - etiology; Humans; Immunoglobulin E - blood; Respiratory Function Tests; Respiratory Hypersensitivity - diagnosis; Respiratory Sounds
• ISSN: 1438-3276

Anamnestic factors of importance are, in particular, acute attacks of shortness of breath, dry cough and symptoms of concomitant rhinoconjunctivitis. Wheezing and other rhonchi are the typical findings on auscultation. Of decisive importance for the diagnosis is spirometry showing reduced values for the one-second/forced vital capacity and the Tiffeneau index. After administration of a beta sympathomimetic, an obstruction can be at least partially reversed. An absent primary obstruction should be inducible by unspecific provocation. On the basis of symptoms and lung function, bronchial asthma is divided into four stages. For establishing the allergic genesis of the illness, additional anamnestic data, in particular concerning the nature of possible allergens, are needed before sensitization is proven by the prick test and the detection of specific IgE antibodies. An equivocal situation can be clarified with the aid of specific nasal--more rarely also bronchial--provocation.