title: A 55-year-old man with severe persistent asthma poorly responsive to asthma therapy.
abstract: Asthma is often triggered by allergic and nonallergic factors in atopic individuals and readily responds to anti-inflammatory and bronchodilator therapy. The differential diagnosis for poorly responsive disease includes severe persistent asthma with associated allergic rhinitis, cardiac  disorders such as left ventricular failure or mitral stenosis, vocal cord dysfunction, gastroesophageal reflux disease, recurrent aspiration, chronic obstructive pulmonary disease, emphysema, alpha-1-antitrypsin deficiency, sarcoidosis, hypersensitivity pneumonitis, bronchiectasis, allergic  bronchopulmonary aspergillosis, airway neoplasm, and Churg-Strauss vasculitis. A careful history and physical in conjunction with appropriate screening of laboratory information will usually direct the clinician to the correct diagnosis.
authors: University Of Medicine and Dentistry of New Jersey, Newark, NJ, USA.
authors: Peter A
authors: PA
authors: Ricketti
authors: Anthony J
authors: AJ
authors: Ricketti
authors: Dennis J
authors: DJ
authors: Cleri
authors: David W
authors: DW
authors: Unkle
authors: John R
authors: JR
authors: Vernaleo
mesh_terms: D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D013902:Radiography, Thoracic; D012129:Respiratory Function Tests; D012135:Respiratory Sounds / Q000175:diagnosis; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis / Q000188:drug therapy; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed
chemical_list: D018927:Anti-Asthmatic Agents