[Advocating the diagnostic criteria for early stage of asthma].
BACKGROUND
In asthmatic patients, first asthmatic symptoms are not often typical. In those cases, it takes long time before asthma diagnosis, and the severities are progressed in some patients. For early intervention, we tried to make the diagnostic criteria for asthma, which are useful to diagnose as early stage of asthma.


METHODS
Three hundred and eighty eight of asthmatic patients, who were recorded first their symptoms in asthma, were enrolled. Their first symptoms and examinations were analyzed.


RESULTS
In first asthmatic symptoms, 79% of patients had cough, 68% patients had wheezing, 49% patients had dyspnoea, and 15% of patients did not have typical asthmatic symptoms in the early stage. The percentages of abnormal in first examinations were 99% in airway hypersensitivity, 92% of low %V25, 82% of eosinophila in sputum and 77% of low %V50. Low FEV1% and reversible airway obstruction were not seen in a lot of patients.


CONCLUSIONS
We advocate that the diagnostic criteria for early stage of asthma are the following three elements. First criterion is spasmodic cough, wheezing and dyspnoea. Second criterion is airway hypersensitivity, or over 3% of eosinophils in sputum, or under 70% of %V50, or under 50% of %V25, or effect of bronchodilator. Effect of bronchodilator will be required, when the symptom is cough only. Third criterion is the exclusion of other lung and heart diseases.
Sugiyama
Kumiya
K
Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University. sugiyama@dokkyomed.ac.jp
Sagara
Hironori
H
Adachi
Mitsuru
M
Minoguchi
Kenji
K
Tanaka
Akihiko
A
Inoue
Hiroshi
H
Yamauchi
Kouhei
K
Kobayashi
Hitoshi
H
Akiyama
Kazuo
K
Tsurikisawa
Naomi
N
Taniguchi
Masami
M
Munakata
Mitsuru
M
Saito
Junpei
J
Sato
Suguru
S
Mishima
Michiaki
M
Niimi
Akio
A
Matsumoto
Hisako
H
Ohta
Ken
K
Adachi
Tetsuya
T
Nagase
Hiroyuki
H
Nakajima
Hiroshi
H
Kagami
Shin-ichiro
S
Iwamoto
Itsuo
I
Fukuda
Takeshi
T
D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D006801:Humans; D008875:Middle Aged