Everything you wanted to know
" Have you got asthma?"


In this patient we demonstrated the presence of bronchial hyperreactivity and eosinophilia. The differential diagnosis in such a case comprise:

1. Asthma (the most common)
• Allergic asthma (extrinsic asthma)
• Non-allergic asthma (intrinsic asthma).

2. Pulmonary diseases (less frequent)
• Chronic obstructive pulmonary disease
• Chronic cough with eosinophilic bronchitis without asthma
• Interstitial pulmonary fibrosis
• Drug and toxin-induced eosinophilic lung diseases
• Helminth and fungal infection-related eosinophilic lung diseases
• Allergic bronchopulmonary aspergillosis
• Chronic eosinophilic pneumonia
• Churg-Strauss syndrome
• Eosinophilic granuloma
• Pleural eosinophilia
• Others forms of pulmonary eosinophilia: neoplasm, tuberculosis.

3. Hypereosinophilic syndrome (very infrequent)
Taking into account the medical history of the patient, and the results of the studies performed, the most probable diagnosis in a 43 years-old female starting at that age with asthma is intrinsic asthma.
However, the patient had an elevated total IgE and a consistent history of exacerbations at home together with an improvement of her asthma symptoms during a 3 days holyday away from home.