4
Diagnosis
Table 4. Diseases Which Can Masquerade as Severe Asthma
Children Adults
Dysfunctional breathing/vocal cord
dysfunction
Dysfunctional breathlessness/vocal cord
dysfunction
Bronchiolitis Chronic obstructive pulmonary disease
Recurrent (micro)aspiration, reflux,
swallowing dysfunction
Hyperventilation with panic attacks
Prematurity and related lung disease Bronchiolitis obliterans
Cystic fibrosis Congestive heart failure
Congenital or acquired immune
deficiency
Adverse drug reaction (e.g., angiotensin-
converting enzyme inhibitors)
Primary ciliary dyskinesia Bronchiectasis/cystic fibrosis
Central airways obstruction/compression Hypersensitivity pneumonitis
Foreign body Hypereosinophilic syndromes
Congenital malformations including
vascular ring
Pulmonary embolus
Tracheobronchomalacia Herpetic tracheobronchitis
Carcinoid or other tumour Endobronchial lesion/foreign body
(e.g., amyloid, carcinoid, tracheal stricture)
Mediastinal mass/enlarged lymph node Allergic bronchopulmonary aspergillosis
Congenital heart disease Acquired tracheobronchomalacia
Interstitial lung disease Churg–Strauss syndrome
Connective tissue disease
