title: Can Reactive Airways Dysfunction Syndrome (RADS) be iatrogenic?
abstract: Reactive airways dysfunction syndrome (RADS) is an asthma-like illness that develops after a single high-level exposure to a pulmonary irritant. Two different cases are reviewed, in which the exposure circumstances were not sufficient to result in adverse health effects yet resulted in persistent respiratory symptoms and a clinical diagnosis of RADS. Potential explanations for an erroneous diagnosis of RADS included an incomplete exposure assessment, medication adverse effects that can contribute to respiratory symptoms, and alternative explanations for respiratory symptoms or test findings. In particular, the empirical use of bronchodilator medications without a clear indication appeared to contribute to continued respiratory symptoms. Without a clear understanding of the patient's exposure, a RADS diagnosis should be carefully considered. The possibility of an iatrogenic sequence of events in which medication adverse effects facilitate respiratory symptoms and a mistaken RADS diagnosis should be considered, particularly in patients who have a poorly defined exposure history.
authors: Center for Toxicology and Environmental Health, North Little Rock, Arkansas 72218, USA. dhewitt@cteh.com
authors: David J
authors: DJ
authors: Hewitt
mesh_terms: D001249:Asthma / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008508:Medication Errors / Q000009:adverse effects*; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D016273:Occupational Exposure / Q000009:adverse effects; D012129:Respiratory Function Tests / Q000379:methods*; D012307:Risk Factors; D013577:Syndrome
chemical_list: D001993:Bronchodilator Agents