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Diagnosis – History Taking |
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As well as general questions about asthma symptoms, consider the following:
1 Atopy is strongly linked with asthma
- Over 90% of children and 80% of adults with asthma are atopic.31, 32
- The presence of eczema is a marker of more severe and/or persistent asthma.33, 34
- Children still wheezing at 6 years are more likely to have a maternal history of asthma and elevated serum IgE levels.12
- Sensitisation to house dust mite and the mould, Alternaria is associated with a high incidence of asthma.35, 36<LE I>
2 Rhinitis
Rhinitis of any cause is a risk factor for asthma (including allergic rhinitis).37, 38
3 Are allergens triggering asthma symptoms?
Timing of symptoms
- Perennial (persistent) or seasonal (intermittent) symptoms.
- Time of day, for example, allergy symptoms provoked by house dust mite are often worse at night and first thing in the morning.
- Time of week, for example, if at weekends consider some activity such as horse-riding, or environment such as old dusty weekenders.
Occupation
- Is there a slow improvement away from the workplace?
- What potential allergen exposures are occurring at work?
Geographic associations of symptoms
- Such as work, home or holidays.
Environmental descriptors
- Conditions at home, such as house age, construction, ventilation, dampness, floor coverings, room clutter, bedding.
- Soft toys in the bedroom.
- Pets in the home.
- Smoking history of family members.
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When should referral to an allergy specialist be considered?
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When there is evidence of continuing poor asthma control despite regular use of preventer medication or if there is regular use of bronchodilators.
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When there are other allergic diseases.
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When foods or food allergy are suspected as asthma triggers.
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In cases of occupational allergy.
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If immunotherapy is contemplated.
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When patients express an interest in exploring allergy issues.
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For further education regarding allergy issues of patient or family.
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Content Updated March 2005
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Last Updated ( Thursday, 24 July 2008 )
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