The terms asthma and chronic obstructive pulmonary disease (COPD) have evolved from their original very specific physiology-based definition to describe additional disease entities such as symptoms, airway inflammation and airway structure.The authors of this review propose that these disease labels should be replaced with a new alphabetical assessment tool for characterizing airway disease, which provides a checklist of 5 relatively independent factors responsible for morbidity in patients with airway disease - ABCDE:
- Airway hyperresponsiveness
- Bronchitis
- Cough reflex hypersensitivity
- Damage to the airway and surrounding lung
- Extrapulmonary factors
Lower Airway Changes in Asthma and COPD
Cellular infiltrate: CD4 in asthma vs. CD8 in COPD.
Differential diagnosis of cough, a simple mnemonic is GREAT BAD CAT TOM. Click here to enlarge the image: (GERD (reflux), Laryngopharyngeal Reflux (LPR), Rhinitis (both allergic and non-allergic) with post-nasal drip (upper airway cough syndrome), Embolism, e.g. PE in adults, Asthma, TB (tuberculosis), Bronchitis, pneumonia, pertussis, Aspiration, e.g foreign body in children, Drugs, e.g. ACE inhibitor, CF in children, Cardiogenic, e.g. mitral stenosis in adults, Achalasia in adults, Thyroid enlargement, e.g. goiter, "Thoughts" (psychogenic), Other causes, Malignancy, e.g. lung cancer in adults).
References:
The A to E of airway disease. Clin Exp Allergy. 2010 Jan;40(1):62-67. Authors: Pavord ID, Wardlaw AJ. http://www.ncbi.nlm.nih.gov/pubmed/20205696
Action plan is a key component of self-management programs in patients with COPD. Thorax, 20111.
Image source: Enlarged view of lung tissue showing the difference between healthy lung and COPD, Wikipedia, public domain.
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