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Spectrum of presentation of paradoxical vocal cord motion in ambulatory patients.
Ann Allergy Asthma Immunol. 1995 Apr; 74(4):341-4.AA

Abstract

BACKGROUND

Paradoxical vocal cord motion (PVCM) frequently masquerades as asthma. Atypical presentations of asthma or situations in which asthma does not respond to traditional therapies mandate the consideration of PVCM in the differential diagnosis.

OBJECTIVE

Evaluate the demographics and spectrum of presentation of PVCM in an ambulatory outpatient population.

METHODS

Retrospective survey of medical records of 164 consecutive patients (86 males, 78 females) who underwent fiberoptic rhinolaryngoscopy over a 3-year period.

RESULTS

Twenty patients (16 females, 4 males) with PVCM diagnosed by direct visualization were identified. Mean age at diagnosis was 33 years (range, 14-58 years). Asthma was the most common presenting diagnosis (15/20, 75%), while the remaining 25% had other unusual presentations including two patients (10%) with PVCM masquerading as anaphylaxis. When PVCM masqueraded as asthma, 44% of those patients were inappropriately treated with oral steroids. Nine patients (45%) had a readily identifiable psychologic trigger of their PVCM.

CONCLUSIONS

Our data confirm previous observations indicating that PVCM is most common in young females and is often associated with psychologic problems. PVCM frequently masquerades as asthma, resulting in overtreatment with corticosteroids. PVCM may also masquerade as stridor, resulting in mimicry of anaphylaxis in the appropriate clinical setting. Thus, PVCM should be considered in any patient presenting with atypical upper and lower respiratory tract symptoms.

Authors+Show Affiliations

Department of Medicine, Fitzsimons Army Medical Center, Aurora, Colorado, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

7719896

Citation

O'Connell, M A., et al. "Spectrum of Presentation of Paradoxical Vocal Cord Motion in Ambulatory Patients." Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, vol. 74, no. 4, 1995, pp. 341-4.
O'Connell MA, Sklarew PR, Goodman DL. Spectrum of presentation of paradoxical vocal cord motion in ambulatory patients. Ann Allergy Asthma Immunol. 1995;74(4):341-4.
O'Connell, M. A., Sklarew, P. R., & Goodman, D. L. (1995). Spectrum of presentation of paradoxical vocal cord motion in ambulatory patients. Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, 74(4), 341-4.
O'Connell MA, Sklarew PR, Goodman DL. Spectrum of Presentation of Paradoxical Vocal Cord Motion in Ambulatory Patients. Ann Allergy Asthma Immunol. 1995;74(4):341-4. PubMed PMID: 7719896.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spectrum of presentation of paradoxical vocal cord motion in ambulatory patients. AU - O'Connell,M A, AU - Sklarew,P R, AU - Goodman,D L, PY - 1995/4/1/pubmed PY - 1995/4/1/medline PY - 1995/4/1/entrez SP - 341 EP - 4 JF - Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology JO - Ann. Allergy Asthma Immunol. VL - 74 IS - 4 N2 - BACKGROUND: Paradoxical vocal cord motion (PVCM) frequently masquerades as asthma. Atypical presentations of asthma or situations in which asthma does not respond to traditional therapies mandate the consideration of PVCM in the differential diagnosis. OBJECTIVE: Evaluate the demographics and spectrum of presentation of PVCM in an ambulatory outpatient population. METHODS: Retrospective survey of medical records of 164 consecutive patients (86 males, 78 females) who underwent fiberoptic rhinolaryngoscopy over a 3-year period. RESULTS: Twenty patients (16 females, 4 males) with PVCM diagnosed by direct visualization were identified. Mean age at diagnosis was 33 years (range, 14-58 years). Asthma was the most common presenting diagnosis (15/20, 75%), while the remaining 25% had other unusual presentations including two patients (10%) with PVCM masquerading as anaphylaxis. When PVCM masqueraded as asthma, 44% of those patients were inappropriately treated with oral steroids. Nine patients (45%) had a readily identifiable psychologic trigger of their PVCM. CONCLUSIONS: Our data confirm previous observations indicating that PVCM is most common in young females and is often associated with psychologic problems. PVCM frequently masquerades as asthma, resulting in overtreatment with corticosteroids. PVCM may also masquerade as stridor, resulting in mimicry of anaphylaxis in the appropriate clinical setting. Thus, PVCM should be considered in any patient presenting with atypical upper and lower respiratory tract symptoms. SN - 1081-1206 UR - https://www.unboundmedicine.com/medline/citation/7719896/Spectrum_of_presentation_of_paradoxical_vocal_cord_motion_in_ambulatory_patients_ L2 - https://medlineplus.gov/asthma.html DB - PRIME DP - Unbound Medicine ER -