title: Atypical expiratory flow volume curve in an asthmatic patient with vocal cord dysfunction.
abstract: BACKGROUND
  Vocal cord dysfunction can coexist with or masquerade as asthma. Vocal cord dysfunction, when coexistent with asthma, contributes substantially to the refractory nature of the respiratory problem.
  
  
  OBJECTIVE
  To report a case of an asthmatic patient with vocal cord dysfunction and a previously unreported unique expiratory flow volume curve.
  
  
  RESULTS
  A 16-year-old female, known to have asthma, developed increased frequency of her asthma exacerbations. Spirometry, during symptoms, showed an extrathoracic airway obstruction with a reproducible unique abrupt drop and rise in the expiratory flow volume loop. Laryngoscopy showed adduction of the vocal cords during inspiration and expiration.
  
  
  CONCLUSIONS
  We report a unique expiratory flow volume curve in an asthmatic with vocal cord dysfunction that resolved with panting maneuvers. Speech and psychological counseling helped prevent future attacks.
authors.affiliation: Division of Immunology, Allergy and Rheumatology, Children's Hospital of Michigan, Detroit 48201, USA. abahrain@pol.net
authors.forename: A H
authors.initials: AH
authors.lastname: Bahrainwala
authors.forename: M R
authors.initials: MR
authors.lastname: Simon
authors.forename: D D
authors.initials: DD
authors.lastname: Harrison
authors.forename: D
authors.initials: D
authors.lastname: Toder
authors.forename: E A
authors.initials: EA
authors.lastname: Secord
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000175:diagnosis; D001249:Asthma / Q000150:complications*; D005260:Female; D006801:Humans; D007828:Laryngoscopy; D008449:Maximal Expiratory Flow-Volume Curves; D012123:Pulmonary Ventilation; D014827:Vocal Cords / Q000473:pathology; D014832:Voice Disorders / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*