title: Actual control state of intermittent asthma classified on the basis of subjective symptoms.
abstract: BACKGROUND
  Many primary care physicians begin treatment of asthma patients on the basis of their subjective symptoms. We hypothesized that patients diagnosed as having intermittent asthma on the basis of subjective symptoms by a primary care physician may have their asthma severity underestimated.
  
  
  METHODS
  We investigated 293 patients who were in their 20s and diagnosed as having asthma. Two hundred and fifteen patients with intermittent asthma diagnosed on the basis of subjective symptoms were chosen. We evaluated their asthma severity using FEV(1) (% predicted), airway hyperresponsiveness to histamine dihydrochloride, and exhaled nitric oxide level as factors that determine asthma severity.
  
  
  RESULTS
  Among these patients, 27.8% were determined to have moderate or severe asthma by the pulmonary function test. History of childhood asthma was the only significant risk factor for a low pulmonary function. Among the patients, 60.9% showed moderate or severe airway hyperresponsiveness. History of childhood asthma was the only significant risk factor for the increase in airway hyperresponsiveness. Moreover, 53.8% showed a high exhaled nitric oxide level. History of childhood asthma was associated with an increased risk of a high eNO level as determined by univariate analysis, but no significant difference was observed in the comparison by multiple logistic regression analysis. The percentage of subjects classified into the mild group by all of the results of the three tests was only 20.6%.
  
  
  CONCLUSIONS
  We showed that asthma severity classified on the basis of only subjective symptoms may be underestimated in young adults. We showed that the diagnosis of mild intermittent asthma needs to be determined carefully.
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Japan. k-sekiya@sagamihara-hosp.gr.jp
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Sekiya
authors.forename: Masami
authors.initials: M
authors.lastname: Taniguchi
authors.forename: Yuma
authors.initials: Y
authors.lastname: Fukutomi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tsuburai
authors.forename: Chihiro
authors.initials: C
authors.lastname: Mitsui
authors.forename: Hidenori
authors.initials: H
authors.lastname: Tanimoto
authors.forename: Chiyako
authors.initials: C
authors.lastname: Oshikata
authors.forename: Naomi
authors.initials: N
authors.lastname: Tsurikisawa
authors.forename: Maki
authors.initials: M
authors.lastname: Hasegawa
authors.forename: Kazuo
authors.initials: K
authors.lastname: Akiyama
mesh_terms: D000328:Adult; D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology*; D016535:Bronchial Hyperreactivity / Q000175:diagnosis / Q000503:physiopathology; D001985:Bronchial Provocation Tests; D045853:Exhalation; D005260:Female; D005541:Forced Expiratory Volume; D006632:Histamine; D006801:Humans; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism; D058007:Physicians, Primary Care; D012129:Respiratory Function Tests; D012307:Risk Factors
chemical_list: D009569:Nitric Oxide; D006632:Histamine