Background:In athletes with exercise-induced asthma, confirmation of the disease with an objective test is required as part of the Therapeutic Use Exemption (TUE) application. An objective diagnosis often requires multiple testing with bronchial provocations and lung function measurements. Currently no guidelines exist on a diagnostic strategy in this group of subjects. Aim:To evaluate the use of diagnostic tests in newly referred athletes with possible exercise-induced asthma in a specialized outpatient clinic. Methods: Medical records on all patients with a suspected diagnosis of asthma referred to the outpatient clinic at Bispebjerg Hospital, Copenhagen, Denmark in 2010 where reviewed, and data on reversibility to beta2-agonist and airway hyperresponsiveness (AHR) to inhaled mannitol, methacholine and eucapnic hyperventilation was collected. Subjects with exercise-induced symptoms that reported to spend at least 10 hours a week on their sports were defined as athletes and were included in the analysis. Results: Of 221 subjects referred with possible asthma to the outpatient clinic, 51 (23%) were athletes with possible exercise-induced asthma. A total of 39/51 (72%) was concluded to have asthma, based on a specialist’s assessment. Among these subjects the final diagnosis was confirmed by an objective test in 31/39 (80%). The number of tests required to confirm the presence of disease was one in 9 (29%) subjects, two in 15 (48%) subjects, three in 6 (19%) and four in 1 (3%) subject. Conclusion: In more than eight out of ten athletes with exercise induced asthma, more than one test for AHR or reversibility was necessary as part of the diagnostic process.
Full conference title:
European Respiratory Society Annual Congress
- ERS 22nd (2012)