Differentiating COPD from asthma in clinical practice.

Publication/Presentation Date

1-1-2007

Abstract

It has been recognized that features of chronic obstructive pulmonary disease (COPD) and asthma overlap, often rendering a firm diagnosis difficult to achieve for the clinical practitioner. There are hypotheses suggesting that both asthma and COPD may indeed share common origins with differences in phenotypic presentation being related to disease evolution or interaction between endogenous and exogenous factors. Others suggest that the two conditions are clinically and pathophysiologically distinct. Studies of the underlying inflammation demonstrate a difference in the preponderance of inflammatory cells and mediators in each disease, yet many shared characteristics in the inflammatory process can be found when examining the two conditions. Generally, later age of presentation favors a diagnosis of COPD; fully reversible airflow limitation on pulmonary function testing suggests a diagnosis of asthma; hyperinflation at rest makes a diagnosis of COPD likely; impaired diffusing capacity is associated with COPD whereas these measurements in patients suffering from asthma are usually normal or even elevated; reduced elastic recoil is the hallmark of COPD, particularly those who pathophysiologically demonstrate abnormal enlargement of air spaces with wall destruction seen in emphysema; and finally history of atopy favors a diagnosis of asthma, particularly if presenting at a younger age. This review reflects discussion of the differences and similarities in diagnosis and treatment.

Volume

22

Issue

5

First Page

300

Last Page

309

ISSN

0885-0666

Disciplines

Medicine and Health Sciences

PubMedID

17895488

Department(s)

Department of Medicine

Document Type

Article

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