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Etiology of asthma: Diagnostic methods
211
Pharmacological Research, Vol. 26, Supplement I, 1992 ETIOLOGY OF ASTHMA: DIAGNOSTIC METHODS Carlo Grassi & *Pietro Zanon Institute of Respiratory Diseases, Pavia University and *Divisione di Pneumologia, Ospedale Busto Arsizio (VA) Asthma is a syndrome with probably different causes and certainly with different precipitating factors and clinical manifestations. In spite of many attempts to give an unambiguous definition of asthma, there is still no agreement on it. Due to this fact there is no uniformity on knowledge and treatment of asthma. So it is important to standardize diagnostic procedures, and to describe accurately the characteristics of each patient. It is necessary to define diagnosis, time course, etiology and triggering factors. Diagnosis is based upon clinical history of wheezing dispnoea not associated to bronchial infections or cardiovascular disorders, detection either of increased resistance to airflow, reversed by bronchodilatators or of hyperreactivity (methacoline, histamine, exercise, ultrasonic mist). Time course can be described monitoring peak flow, possibly in relationship with exposure to various stimuli. Etiology can be evaluated looking for sensitivity to environmental or occupational allergens with skin prick tests and/or detection of specific IgE with RAST or ELISA. In a half of patients such sensitivity cannot be found: it could be necessary to perform bronchoprovocation or exposition tests against suspected allergens, occupational agents, aspirin, foods or food additives. In some cases it is useful to consider gastroesophageal reflux or fungal infection. To be considered also: irreversible, infectious and bronchitic components; exacerbation by hyperventilation, exercise and cold air; sputum and blood eosinophils; nasal polyposis and sinusitis.
A S T H M A MEDIATORS AND CELLS E. Pozzi Chair of versity,
Respiratory Turin, Italy
Physiopathology
Faculty
of
Medicin
and Surgery,
Uni-
Pharmacological Research, Vol. 26, Supplement I, 1992 ETIOLOGY OF ASTHMA: DIAGNOSTIC METHODS Carlo Grassi & *Pietro Zanon Institute of Respiratory Diseases, Pavia University and *Divisione di Pneumologia, Ospedale Busto Arsizio (VA) Asthma is a syndrome with probably different causes and certainly with different precipitating factors and clinical manifestations. In spite of many attempts to give an unambiguous definition of asthma, there is still no agreement on it. Due to this fact there is no uniformity on knowledge and treatment of asthma. So it is important to standardize diagnostic procedures, and to describe accurately the characteristics of each patient. It is necessary to define diagnosis, time course, etiology and triggering factors. Diagnosis is based upon clinical history of wheezing dispnoea not associated to bronchial infections or cardiovascular disorders, detection either of increased resistance to airflow, reversed by bronchodilatators or of hyperreactivity (methacoline, histamine, exercise, ultrasonic mist). Time course can be described monitoring peak flow, possibly in relationship with exposure to various stimuli. Etiology can be evaluated looking for sensitivity to environmental or occupational allergens with skin prick tests and/or detection of specific IgE with RAST or ELISA. In a half of patients such sensitivity cannot be found: it could be necessary to perform bronchoprovocation or exposition tests against suspected allergens, occupational agents, aspirin, foods or food additives. In some cases it is useful to consider gastroesophageal reflux or fungal infection. To be considered also: irreversible, infectious and bronchitic components; exacerbation by hyperventilation, exercise and cold air; sputum and blood eosinophils; nasal polyposis and sinusitis.
A S T H M A MEDIATORS AND CELLS E. Pozzi Chair of versity,
Respiratory Turin, Italy
Physiopathology
Faculty
of
Medicin
and Surgery,
Uni-