Pediatric Asthma Differential Diagnoses

  • Author: Girish D Sharma, MD; Chief Editor: Michael R Bye, MD   more...
 
Updated: Mar 12, 2012
 
 

Diagnostic Considerations

Problems to be considered include the following:

  • Tracheobronchomalacia
  • Hyperventilation syndrome
  • Vocal cord dysfunction
  • Pulmonary edema
  • Collagen vascular disease
  • Reactive airway disease

Differentials

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Girish D Sharma, MD  Professor of Pediatrics, Rush Medical College; Senior Attending, Department of Pediatrics, Director, Section of Pediatric Pulmonology and Rush Cystic Fibrosis Center, Rush University Medical Center

Girish D Sharma, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society, and Royal College of Physicians of Ireland

Disclosure: Nothing to disclose.

Coauthor(s)

Payel Gupta, MD  Department of Allergy and Immunology, ENT Faculty Practice

Payel Gupta, MD is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Thomas Scanlin, MD  Chief, Division of Pulmonary Medicine and Cystic Fibrosis Center, Department of Pediatrics, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School

Thomas Scanlin, MD is a member of the following medical societies: American Association for the Advancement of Science, American Society for Biochemistry and Molecular Biology, American Thoracic Society, Society for Pediatric Research, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Charles Callahan, DO  Professor, Deputy Chief of Clinical Services, Walter Reed Army Medical Center

Charles Callahan, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American College of Osteopathic Pediatricians, American Thoracic Society, Association of Military Surgeons of the US, and Christian Medical & Dental Society

Disclosure: Nothing to disclose.

Chief Editor

Michael R Bye, MD  Professor of Clinical Pediatrics, Division of Pulmonary Medicine, Columbia University College of Physicians and Surgeons; Attending Physician, Pediatric Pulmonary Medicine, Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University Medical Center

Michael R Bye, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, and American Thoracic Society

Disclosure: Nothing to disclose.

References

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Table 1. Stepwise Approach to Asthma Medications
Intermittent AsthmaPersistent Asthma: Daily Medication
AgeStep 1Step 2Step 3Step 4Step 5Step 6
< 5 yRapid-acting beta2-agonist prnLow-dose inhaled corticosteroid (ICS)Medium-dose ICSMedium-dose ICS plus either long-acting beta2-agonist (LABA) or montelukastHigh-dose ICS plus either LABA or montelukastHigh-dose ICS plus either LABA or montelukast; Oral systemic corticosteroid
Alternate regimen: cromolyn or montelukast
5-11 yRapid-acting beta2-agonist prnLow-dose ICSEither low-dose ICS plus either LABA, LTRA, or theophylline OR Medium-doseMedium-dose ICS plus LABAHigh-dose ICS plus LABAHigh-dose ICS plus LABA plus oral systemic corticosteroid
Alternate regimen: cromolyn, leukotriene receptor antagonist (LTRA), or theophyllineAlternate regimen: medium-dose ICS plus either LTRA or theophyllineAlternate regimen: high-dose ICS plus either LABA or theophyllineAlternate regimen: high-dose ICS plus LRTA or theophylline plus systemic corticosteroid
12 y or olderRapid-acting beta2-agonist as neededLow-dose ICSLow-dose ICS plus LABA OR Medium-dose ICSMedium-dose ICS plus LABAHigh-dose ICS plus LABA (and consider omalizumab for patients with allergies)High-dose ICS plus either LABA plus oral corticosteroid (and consider omalizumab for patients with allergies)
Alternate regimen: cromolyn, LTRA, or theophyllineAlternate regimen: low-dose ICS plus either LTRA, theophylline, or zileutonAlternate regimen: medium-dose ICS plus either LTRA, theophylline, or zileuton
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