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Differential diagnosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The differential diagnosis of asthma varies with age:

  • 6-11 years
    • chronic upper airway cough syndrome -sneezing, itching, blocked nose, throat-clearing
    • inhaled foreign body - sudden onset of symptoms, unilateral wheeze
    • bronchiectasis - recurrent infections, productive cough
    • primary ciliary dyskinesia - recurrent infections, productive cough, sinusitis
    • congenital heart disease - cardiac murmurs
    • bronchopulmonary dysplasia - pre-term delivery, symptoms since birth
    • cystic fibrosis - excessive cough and mucus production, gastrointestinal symptoms
  • 12-39 years
    • chronic upper airway cough syndrome - sneezing, itching, blocked nose, throat-clearing
    • vocal cord dysfunction - dyspnea, inspiratory wheezing (stridor)
    • hyperventilation, dysfunctional breathing - dizziness, paresthesia, sighing
    • bronchiectasis - productive cough, recurrent infections
    • cystic fibrosis - excessive cough and mucus production
    • congenital heart disease - cardiac murmurs
    • alpha1-antitrypsin deficiency - shortness of breath, family history of early emphysema
    • inhaled foreign body - sudden onset of symptoms
  • 40+ years
    • vocal cord dysfunction - dyspnea, inspiratory wheezing (stridor)
    • hyperventilation, dysfunctional breathing - dizziness, paresthesia, sighing
    • COPD - cough, sputum, dyspnea on exertion, smoking or noxious exposure
    • bronchiectasis - productive cough, recurrent infections
    • cardiac failure - dyspnea with exertion, nocturnal symptoms
    • medication-related cough - treatment with angiotensin converting enzyme (ACE) inhibitor
    • parenchymal lung disease - dyspnea with exertion, non-productive cough, finger clubbing
    • pulmonary embolism - sudden onset of dyspnea, chest pain
    • central airway obstruction - dyspnea, unresponsive to bronchodilators
  • All ages
    • Tuberculosis - chronic cough, hemoptysis, dyspnea; and/or fatigue, fever, (night) sweats, anorexia, weight loss
    • Pertussis - prolonged paroxysms of coughing, sometimes stridor

Reference:

  1. Global Initiative For Asthma (GINA) 2023. Global strategy for asthma management and prevention

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