Abstract
Introduction: Asthma can be defined as a chronic inflammatory disorder of airways characterized by inflammation of airway, intermittent airway obstruction and bronchial hyper responsiveness. Though bronchial asthma is more common in pediatric age groups and manifests as recurrent episodes of cough, wheezing and tachypnea (in infants) or breathlessness (in older children) in many of the instances the first episode of symptoms may occur in older individuals in which instance it is known as adult onset asthma. It is important to keep this differential diagnosis in mind in any patient presenting with recurrent cough and episodes of wheezing.
Materials and Methods: This was a prospective study in which 60 patients with late onset asthma were included on the basis of a predefined inclusion and exclusion criteria. Patients having respiratory or cardiac co-morbidities which may have a bearing on clinical features and spirometry results were excluded from the study. Detailed history was taken in all the cases and a through clinical examination was taken. Spirometry was done in all the cases. FEV1 values (Percentage of expected FEV1) and Forced expiratory flow at 25-75% of the pulmonary volume (FEF25-75%) was determined in all the cases.
Results: Out of the 60 patients enrolled in this study females were more commonly affected as compared to males with a M:F ratio of 1:2.3. The mean age of the male patients was found to be 49.66 +/- 6.11 years whereas the mean age of female patients was found to be 46.73 +/- 5.98 years.28 patients (46.67%) had symptoms for 6-10 years. 22 patients (36.67%) had symptoms for 2-5 years. 8 patients (13.33%) had symptoms since less than 2 years whereas 2 (3.33%) patients had duration of symptoms more than 10 years. Out of the studied cases majority of the patients (32/60) were having FEV1 value of more than 70% of expected followed by mild (12/60) and moderately severe asthma (8/60).38 (63.33%) patients had FEF(25-75%) more than 80% while remaining 22 (36.66%).
Conclusion: Late onset Asthma is increasing with increase in environmental pollution. Its possibility must be kept in mind and should be considered in any adult patient who presents with recurrent episodes of cough and wheezing. Spirometry will help in the diagnosis and alternative diagnosis should be excluded by appropriate investigations.
Keywords: Late onset Asthma, Recurrent Wheezing, Spirometry, FEV1.
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Corresponding Author
Dr Fahad Aleem
Pulmonolgist KNG hospital, Kuwait
DOI: https://dx.doi.org/10.18535/jmscr/v8i8.13
