Vocal chord dysfunction masquerading asasthma?
Report from December 2007:
Vocal cord dysfunction masquerading as "asthma" for 20 years
A 39-year-old Caucasian female with a diagnosis of allergic rhinitis and asthma for 20 years is referred for evaluation to the allergy clinic. She was on Advair for two years, approximately four years ago, and then Advair was stopped by by her pulmonologist because her pulmonary function tests were normal.
She is here for evaluation of allergic rhinitis by skin prick testing. She has increased shortness of breath with exercise. She reports loss of voice, cough, and shortness of breath when eating or laughing. The symptoms occur throughout the year. She also reports nasal congestion and for that, she takes Allegra D QAM and Allegra QPM .
She rates the nasal symptoms as 5 out of 10 on a zero to 10 scale, when she is off the medication, and down to 1 to 2 out of 10 when she takes Allegra D. She also reports dry cough for 20 years which does not respond to albuterol. She exercises daily and uses albuterol 30 to 60 minutes before exercise, and then during her exercise routine for cough, change in her voice and shortness of breath.
Thealbuterol helps, but it does not relieve her symptoms completely. She was on intranasal steroids in the past, but the spray was used inconsistently and she does not recall the effect of this treatment.
VCD frequently mimics persistent asthma and is often treated with high-dose inhaled and/or systemic corticosteroids, bronchodilators, and may lead to multiple emergency department visits and hospitalizations.
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First Published in December 2007 updated January 2010