title: [Severe breathlessness in a patient presenting with chronic bronchitis].
abstract: BACKGROUND
  Dyspnoea is the major symptomatic complaint of patients with chronic obstructive pulmonary disease (COPD). Awareness of an unpleasant respiratory sensation, occurs through a complex system of ventilatory control where, as in pain perception, supra-bulbar structures play a major role. In the hyperventilation syndrome, dramatic episodes of dyspnea can occur without any change in peripheral afferent signals and thus do not predictably represent a real deterioration in pulmonary function in patients who also have COPD.
  
  
  METHODS
  We report the observation of a patient with GOLD stage 0 COPD who demonstrated a major limitation of daily activities due to supra-bulbar influences on respiratory control which triggered repetitive periods of hyperventilation and generated almost constant dyspnea.
  
  
  CONCLUSIONS
  Hyperventilation syndrome can be difficult to diagnose in patients with respiratory disease, although, in most cases, the discrepancy between the severity of symptomatic complaint compared to the degree of alteration of lung function in combination with specific tests may suggest the diagnosis.
authors.affiliation: Laboratoire de Physiologie, Faculté de Médecine de Nancy, EA 3450, Service des Explorations Fonctionnelles Respiratoires, Centre Hospitalier Universitaire de Nancy, Vandoeuvre-lès-Nancy, France.
authors.forename: B
authors.initials: B
authors.lastname: Chenuel
authors.forename: P
authors.initials: P
authors.lastname: Haouzi
mesh_terms: D029481:Bronchitis, Chronic / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D006985:Hyperventilation / Q000175:diagnosis / Q000209:etiology*; D016857:Hypocapnia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D013577:Syndrome