![]() ![]() 8 As a result, there is a lack of data regarding outcomes and treatment options for patients with this disease. 6,7 Despite the condition’s prevalence, most clinical trials studying COPD or asthma exclude patients that likely have ACOS. 5 Patients with ACOS typically report more wheezing and dyspnea, have more frequent exacerbations, and report a poorer health-related quality of life than patients with COPD alone. 4 Clinical suspicion for ACOS should be high in individuals 40 years of age and older with dyspnea on exertion, a significant smoking history (>10 pack years), and fixed airway obstruction on pulmonary function tests who also report a clinical history or symptoms consistent with asthma (wheezing, nocturnal symptoms, improvement with inhaled corticosteroids). 1,2 A significant percentage of patients diagnosed with obstructive lung disease have ACOS 2,3 but the prevalence varies from 2.1% to 55% depending on the diagnostic criteria used. There is little consensus for the definition of asthma-COPD overlap syndrome (ACOS) or for methods of diagnosing the condition. ![]() His laboratory values are notable for an absolute eosinophil count of 600 cells per microliter and an elevated IgE of 1130 IU/mL. His diffusing capacity for carbon monoxide is reduced to 53% of the predicted value. His lung volume measurement reveals a normal total lung capacity (TLC) and a high residual volume (137% of the predicted value). He has a significant bronchodilator response with an FEV 1 improvement of 19%. His pulmonary function test shows evidence of moderate airflow obstruction (forced expiratory volume in 1 second / forced vital capacity of 55%, FEV 1 1.79 liters or 59% predicted). His physical examination is significant for scant wheezing and an oxygen saturation of 95% on room air. He reports a history of allergic rhinitis. During the last year he has required multiple courses of steroids and antibiotics for exacerbations of his lung disease. The patient was diagnosed with chronic obstructive pulmonary disease (COPD) 15 years ago. doi: Case StudyĪ 69-year-old man with a 40 pack-year history of cigarette smoking presents with paroxysmal dyspnea and wheezing. Images in COPD: asthma-COPD overlap syndrome. Running Head: Images in COPD: Asthma-COPD OverlapĪbbreviations: chronic obstructive pulmonary disease, COPD forced expiratory volume in 1 second, FEV 1 forced vital capacity, FVC total lung capacity, TLC asthma-COPD overlap syndrome, ACOS high-resolution computed tomography, HRCT computed tomography, CTĬitation: Marron RM, Vega Sanchez ME. ![]()
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