Summary
Definition
History and exam
Key diagnostic factors
- recent upper respiratory tract infection
- dyspnea
- cough
- expiratory wheezes
- nasal polyposis
Risk factors
- family history
- allergens
- atopic history
- nasal polyposis
- obesity
- gastroesophageal reflux
- obstructive sleep apnea
Diagnostic investigations
1st investigations to order
- FEV₁/FVC ratio
- peak expiratory flow rate (PEFR)
- CXR
- CBC
Investigations to consider
- bronchial challenge test
- immunoassay for allergen-specific IgE
- skin prick allergy testing
- fractional exhaled nitric oxide (FeNO)
Treatment algorithm
Contributors
Authors
Fellow
Division of Pulmonary and Critical Care Medicine
Department of Medicine
Stanford University School of Medicine
Stanford
CA
Disclosures
LE declares that she has no competing interests.
Clinical Assistant Professor (Affiliated)
Division of Pulmonary and Critical Care Medicine
Department of Medicine
Stanford University School of Medicine
Stanford
CA
Disclosures
SM declares that he has no competing interests.
Dr Lauren Eggert and Dr Sourav Majumdar would like to gratefully acknowledge Dr Irwani Ibrahim, Dr Kay Choong See, Dr Francis Thien, and Dr Catherine Weiler, previous contributors to this topic.
Disclosures
II, KCS, FT, and CW declare that they have no competing interests.
Peer reviewers
Clinical Director
Division of Allergy and Inflammation
Beth Israel Deaconess Medical Center/Harvard Medical School
Boston
MA
Disclosures
JS is a consultant for Aventis, GSK, and Novartis/Genentech; is on the Speakers Bureau for Merck, Aventis, GSK, AstraZeneca, Pfizer, Novartis/Genentech, Inspire, and UCB; has had research sponsored by GSK; is an expert witness at Haemonetics; and has received publication honorarium at Emedicine.
Research Manager
Imperial College Healthcare Trust
NHLI Airways Division
Imperial College London (Honorary) Respiratory Research
Chest & Allergy
St Mary's Hospital
London
UK
Disclosures
SMSS declares that she has no competing interests.
Professor of Respiratory Medicine
Respiratory Medicine Section
Division of Immunology, Infection & Inflammation
University of Glasgow
Glasgow
UK
Disclosures
NT declares that he has no competing interests.
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