Child Asthma Diagnoses

[msb]

My son who is 8 years old has been diagnosed with moderate asthma via a methacholine challenge (dropped 24% on second dose).  However his asthma is atypical because when induced with the methacholine challenge he did not have wheezing or difficulty breathing.  Instead he continually attempted to clear his throat and complained of tightening in his throat.  I am very concerned and confused by this diagnoses because he has had a total of 6 attacks in the past 3 years.   All attacks have been the same,  he wakes up early in the morning with a hoarse odd sounding cough and has difficulty inhaling.  The asthma rescue meds (xopenex) does nothing to help even after 3 or 4 treatments.  We then take him to the ER and they tell us that he has a stridor and that he has the croup virus and it is not asthma.  He is generally prescribed and oral steroid which clears it up and sent home,  but he will develop a cold or viral symptoms like runny nose and cough.  He has been on a asthma maintenance med Pulmacort for 2 years and it does not seam to help.   He never has needed to use his rescue inhaler, other than the 6 croup attacks which did nothing to help anyway.   He does not wheeze or have trouble breathing,  just throat clearing.  His peak flows are always about the same. To prepare him for the methacholine challenge test we took him off the Pulmacort for 6 weeks and he had no difficulty or change.  Is there any possibility that we may not be dealing with asthma and maybe something else like VCD (vocal cord dysfunction)????   Our doctor says asthma,  the ER docs say stridor and croup????  Any help would be appreciated.

[National Jewish]

From the information you have presented, it is very possible that your son does NOT have asthma.  The symptoms and the lack of response to medicines suggest upper airway obstruction rather than asthma.  Vocal cord dysfunction (VCD) is a possible cause of symptoms like these and also a lack of response.  Some people with VCD respond to methacholine positively, but the curves look different on the graphs.  Having your son evaluated by a pediatric pulmonologist might be a good idea.

[Inanga]

i was given asthma drugs by one casual doctor - it turned out to be food reactions causing masses of mucous - could not sleep for choking on the stuff and was always coughing. Started by avoiding wheat and gluten and got a lot better then identified dairy as a cause for me too.

I'd reccomend doing an emimination diet - get help if you need. There's lots of background info out there. Geting professional help might get you a result quicker than doing it yourself.

all the best

[jewel464g]

My younger cousin has similar problem, turns out he has some bad food allergies.  Anytime he eats beef his throat seems to close up on him and he has a hard time breathing.  Took them months to finally figure out what was going on with him.  Might want to have him tested.