Study Some Kids Are Being Misdiagnosed With Asthma

Main Category: Respiratory / Asthma
Also Included In: Pediatrics / Children's Health
Article Date: 01 Sep 2007 - 1:00 PDT

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It's the most common chronic condition facing kids in this country - more than 6 million children have been diagnosed with asthma.* But how many have been misdiagnosed? A new study suggests that some of those kids actually don't have asthma - they have a very different condition requiring very different treatment.

As a hockey goalie, Logan Davis has to be ready for anything. But during a game last season, he experienced something he never saw coming… suddenly, Logan couldn't breathe.

"My whole throat was closed. I just couldn't skate. It was scary," says Davis.

It happens to hundreds of thousands of kids every year in this country.* Most end up in the emergency room diagnosed with asthma.

"Physicians in an emergency setting see this and someone says 'It's an asthma attack!' and they tend to treat the child for that and often admit them to the hospital," says Karen McCoy, MD, at Columbus Children's Hospital.

But Dr. McCoy says that can be a mistake. A recent study performed at Columbus Children's Hospital found three out of four children who had good oxygen levels and appeared to have asthma actually had a condition known as vocal cord dysfunction - or VCD.** The symptoms are similar, but the treatments are vastly different. Kids with VCD are simply taught breathing exercises to help them cope. Children with asthma need medicine, sometimes steroids, to get better.

A simple breathing test called spirometry can tell doctors the difference. Dr. McCoy says just a few seconds on the machine may keep kids who don't have asthma out of the hospital.

"And most importantly, not expose these kids to medications that may have tremendous negative side effects for them," says McCoy.

This study only looked at a snapshot of some 20 cases, but it raises serious questions. If asthma was ruled out in 15 of these cases, how many other children across the country are being treated for asthma they don't really have?

It's important to point out that children can suffer from both asthma and VCD. Dr. McCoy says further study of a wider sample of cases is needed, but if more emergency rooms made use of the spirometry breathing test, it could cut down on the number of kids who are misdiagnosed and even hospitalized unnecessarily.

*Asthma & Kids Fact Sheet/Natl Center for Health Statistics, American Lung Association, August 2006 - http://www.lungusa.org

**Pulse Oximetry Coupled With Spirometry in the Emergency Department Helps Differentiate and Asthma Exacerbation From Possible Vocal Cord Dysfuntion, Pediatric Pulmonology, July 2007, Volume 42 Issue 7, pages 605-609

Ohio State University