title: [Severe asthma was found to be an asthma-like condition. Consider reduced doses of cortisone].
abstract: A middle-aged man with variable breathing problems and frequent acute attacks, diagnosed as severe bronchial asthma, was given high-dose oral corticosteroid treatment. Owing to the somewhat atypical history, and normal lung function test results despite severe concomitant asthma-like symptoms, the diagnosis was reconsidered. As a new diagnostic work-up showed the presence of a disease of slight to moderate severity, it was decided to taper off the corticosteroid treatment. Within one year the daily dose of prednisolone was decreased from 40 to 7.5 mg without deterioration of the airway symptoms or impairment of lung function. Re-evaluation also showed the principal diagnosis not to be bronchial asthma but an asthma-like condition (functional breathing disorder combined with sensory hyperresponsiveness), and alternative not previously considered and a condition in which steroids are without apparent effect. This case illustrates the importance of a critical re-view of the diagnosis before high-dose corticosteroid treatment with its inevitable side effects is instituted.
authors.affiliation: allergidivisionen, Sahlgrenska sjukhuset, Göteborg.
authors.forename: O
authors.initials: O
authors.lastname: Löwhagen
authors.forename: S
authors.initials: S
authors.lastname: Ellbjär
authors.forename: N
authors.initials: N
authors.lastname: Jörgensen
authors.forename: L
authors.initials: L
authors.lastname: Toss
mesh_terms: D000208:Acute Disease; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D003348:Cortisone / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage*
chemical_list: D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D003348:Cortisone; D011241:Prednisone
vernacular_title: Svor astma visade sig vara astmaliknande tillstånd. Beakta möjligheten sänka kortisondosen.