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Reactive airway disease (RAD) vs Asthma


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Reactive airway disease is specific to an exogenous trigger (eg pollen, 2nd hand smoke) and is often resolved with elimination of that trigger. It is typically more mild than asthma. Asthma is a chronic inflammatory disease that is less likely to resolve and is typically more severe than RAD. The two are sometimes used interchangeably but should not be. Finally, RAD may be diagnosed simply by a presentation that includes wheezing, whereas asthma includes a more thorough workup such as PFT.

 

From Mayo Clinic:

Sometimes the terms "reactive airway disease" and "asthma" are used interchangeably. Often, the term "reactive airway disease" is used when asthma is suspected, but not yet confirmed.

Reactive airway disease in children is a general term that doesn't indicate a specific diagnosis. It may be used to describe a history of coughing, wheezing or shortness of breath triggered by infection. These signs and symptoms may or may not be caused by asthma.

Describing a condition as reactive airway disease in part reflects the difficulty in establishing a diagnosis of asthma in certain situations — such as during early childhood. Although it's possible for infants and toddlers to have asthma, tests to diagnose asthma generally aren't accurate before age 6.

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Guest Paula
i remember a slide from a leading asthma expert. It listed all these terms ASTHMA, RAD, ALLERGIC COUGH, etc and they all faded and said they mean ASTHMA.

 

I agree. I just attended a conference and one topic was on asthma. The pulmonologist said the same thing. It is asthma. Do a good workup on the patient and help them to reduce the number of times they have an asthma exacerbation (RAD).

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RAD is the to pt whom never wheezes unless they are sick and its only MILD wheezing. The difference for me this kid whom gets sick 1-2 times a year does not need preventative tx or even a rescue inhaler as he may use it 1-2 times a year. I treat them differently. They have a rescue inhaler at home, but don't need to carry it, no inhaled steroids and when they get sick I'm more aggressive in treatment and f/u. Think if this patient like an asthma kid that only has asthma when sick. Also these kids often have normal spirometry when not acutely ill

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