title: High prevalence of exercise-induced laryngeal obstruction in athletes.
abstract: BACKGROUND
  Unexplained respiratory symptoms reported by athletes are often incorrectly considered secondary to exercise-induced asthma. We hypothesized that this may be related to exercise-induced laryngeal obstruction (EILO). This study evaluates the prevalence of EILO in an unselected cohort of athletes.
  
  
  METHODS
  We retrospectively reviewed the prevalence of EILO in a cohort of athletes (n = 91) referred consecutively during a 2-yr period for asthma workup including continuous laryngoscopy during exercise (CLE) testing. We compared clinical characteristics and bronchial hyperreactivity between athletes with and without EILO.
  
  
  RESULTS
  Of 88 athletes who completed a full workup, 31 (35.2%) had EILO and 38 (43.2%) had a positive bronchoprovocation or bronchodilator reversibility test. The presence of inspiratory symptoms did not differentiate athletes with and without EILO. Sixty-one percent of athletes with EILO and negative bronchoprovocation and bronchodilator reversibility tests used regular asthma medication at referral.
  
  
  CONCLUSIONS
  In athletes with unexplained respiratory symptoms, EILO is an important differential diagnosis not discerned from other etiologies by clinical features. These findings have important implications for the assessment and management of athletes presenting with persistent respiratory symptoms despite asthma therapy.
authors: 1Respiratory Research Unit, Department of Respiratory Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, DENMARK; and 2Department of Respiratory Medicine, Royal Brompton Hospital, London, England, UNITED KINGDOM.
authors: Emil Walsted
authors: EW
authors: Nielsen
authors: James H
authors: JH
authors: Hull
authors: Vibeke
authors: V
authors: Backer
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use; D000328:Adult; D000402:Airway Obstruction / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy; D001985:Bronchial Provocation Tests; D001993:Bronchodilator Agents / Q000494:pharmacology; D002648:Child; D003937:Diagnosis, Differential; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D007828:Laryngoscopy; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D001993:Bronchodilator Agents; D020024:Leukotriene Antagonists