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TOPICS
Overview
Allergic bronchopulmonary aspergilllosis (ABPA)
Anaphylaxis - Updated
Asthma
Asthma Diagnosis
Environmental diagnosis
and management
Asthma Treatment:
Immunotherapy
Asthma Treatment:
Preventing Morbidity
- Updated
Asthma Treatment:
Preventing Mortality

- Updated
Asthma Treatment:
Adherence
Occupational Asthma
Conjunctivitis
Cough
Dermatitis
Atopic - Updated
Contact
Drug Allergy - Updated
Food Allergy - Updated
Hypersensitivity Pneumonitis
Insect Hypersensitivity
Occupational Diseases
Primary Immune Deficiency - Updated
Rhinitis/Rhinosinusitis
Rhinitis - Updated
Sinusitis
Urticaria/Angioedema - Updated
How the Allergist/Immunologist Can Help:
Consultation and Referral Guidelines Citing the Evidence

Disease Group: Asthma Diagnosis
  1. Patients with respiratory symptoms suggestive of asthma but with normal PFT (FEV1 > 70 % predicted) and no significant reversibility (< 15 % increase in FEV1).
    [Rationale]
  2. Exercise-induced symptoms that are atypical or do not respond well to pre-treatment with albuterol, nedocromil, or cromolyn.
    [Rationale]
  3. Subjects wishing to scuba dive with a history of asthma
    [Rationale]





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Allergist/immunologists perform methacholine challenges, which have a high sensitivity for current asthma.1, 2
Diagnostic
Further objective evaluation and confirmation with pulmonary function testing (including exercise challenge) in conjunction with appropriate allergist/immunologist evaluation will define diagnosis or differential diagnosis.3
Diagnostic
There is a theoretical risk of increased barotrauma as well as exercise-induced bronchospasm in patients with asthma who scuba dive. Bronchoprovocation with exercise has been recommended to exclude asthma in scuba divers.4
Diagnostic

Indirect outcome (scuba diving avoidance)