Sinusitis and chronic progressive exercise-induced cough and dyspnea.

Abstract

We present the case of a 47-year-old man with exercise-induced dyspnea, cough, chest tightness, and recalcitrant chronic rhinosinusitis. Evaluation revealed IgE sensitization to grass, tree, and weed pollen, no evidence of obstruction on spirometry, and a negative methacholine challenge. Diagnostic considerations included allergic and nonallergic rhinitis, asthma, aspirin-exacerbated respiratory disease, vocal cord dysfunction, extra-esophageal manifestations of acid reflux, and vasculitits. Further evaluation with sinus imaging, laryngoscopy, ambulatory pharyngeal pH testing, upper endoscopy, and bronchoscopy led to a diagnosis. Key issues surrounding the diagnostic and therapeutic approaches to this patient's condition are reviewed.

• Authors: Adam N Williams, Ronald A Simon, Katharine M Woessner
• Journal: Allergy and asthma proceedings (Allergy Asthma Proc) 2008 Nov-Dec Vol. 29 Issue 6 Pg. 669-75 ISSN: 1088-5412 [Print] United States
• PMID: 19173793 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunoglobulin E

Topics

• Chronic Disease
• Cough (diagnosis, etiology, immunology, therapy)
• Diagnosis, Differential
• Dyspnea (diagnosis, etiology, immunology, therapy)
• Exercise
• Humans
• Immunoglobulin E (blood)
• Male
• Middle Aged
• Sinusitis (complications, diagnosis, immunology, therapy)