Triggers of Breathlessness in Inducible Laryngeal Obstruction and Asthma

Haines, Jemma; Chua, Sarah HK; Smith, Jacky; Slinger, Claire; Simpson, Andrew J.; Fowler, Stephen J

Abstract

Background
Inducible laryngeal obstruction (ILO) is often misdiagnosed as, or may coexist with, asthma. Identifying differences in triggering factors may assist clinicians to differentiate between the two conditions, and could give mechanistic insights.

Objective
To identify and compare patient‐reported triggers in ILO and asthma.

Methods
This was a two‐part study. Initially we conducted a retrospective case note review of the triggers of ILO from endoscopically‐confirmed ILO patients to generate a Breathlessness Triggers Survey (BrTS). Triggers were categorised as: scents, environmental factors, temperature, emotions, mechanical factors and daily activities. Secondly, ILO and/or asthma patients completed the BrTS prospectively, rating the likelihood of each item triggering their symptoms using a five‐point Likert scale (strongly disagree to strongly agree). Chi‐square testing was performed to compare responses by cohort.

Results
Data from 202 patients with ILO [73% female, mean (SD) age 53(16) years] were included in the case note review. For the prospective study, 38 patients with ILO‐only [63% females, age 57(16) years], 39 patients with asthma‐only [(56% female, age 53(13) years] and 12 patients with both ILO and asthma [83% female, mean age, 57 (14) years)] completed the BrTS. The triggers identified in the case note review were confirmed in the independent sample of patients with ILO and/or asthma and identified several difference in prevalence of the triggers between disease types. Mechanical factors [talking (p

Citation

Haines, J., Chua, S. H., Smith, J., Slinger, C., Simpson, A. J., & Fowler, S. J. (2020). Triggers of Breathlessness in Inducible Laryngeal Obstruction and Asthma. Clinical and Experimental Allergy, 50(11), 1230-1237. https://doi.org/10.1111/cea.13715

• Journal Article Type: Article
• Acceptance Date: Jul 14, 2020
• Online Publication Date: Jul 26, 2020
• Publication Date: 2020-11
• Deposit Date: Jul 27, 2020
• Publicly Available Date: Jul 27, 2020
• Journal: Clinical and Experimental Allergy
• Print ISSN: 0954-7894
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 50
• Issue: 11
• Pages: 1230-1237
• DOI: https://doi.org/10.1111/cea.13715
• Keywords: Allergens and epitopes; Asthma; Environment; Hygiene hypothesis and Inducible laryngeal obstruction
• Public URL: https://hull-repository.worktribe.com/output/3548183
• Publisher URL: https://onlinelibrary.wiley.com/doi/abs/10.1111/cea.13715
• Additional Information: Published: 2020-07-26