Real and Pseudo Late Asthmatic Reactions after Submaximai Exercise Challenge in Patients with Bronchial Asthma: Discussion (2)

In: Asthma

30 Jan 2013

Real and Pseudo Late Asthmatic Reactions after Submaximai Exercise Challenge in Patients with Bronchial Asthma: Discussion (2)The pattern of the LAR in these eight patients showed a variable pattern. The PEFR 4 to 13 hours after EC may fall to return quickly to baseline values, remain down for a long time, or decrease progressively (Fig 1). These findings are in accordance with the literature, in which no sigificant differences were observed in clinical severity of asthma, age, sex, atopic status, and histamine PC20 between patients with a single EAR and patients with both an EAR and LAR.* An early fall ^20 percent occurred more than two times as often in patients with a LAR as compared with patients with a late fall in PEFR <20 percent. asthma inhalers

There was no difference, however, in EAR between the groups with a real and with a pseudo LAR. Two patients with a pseudo LAR and one patient with a real LAR did not have an EAR in our study. The more severe the early fall in PEFR, the greater the probability for a severe late fall in PEFR to occur. But a LAR to EC can occur without a preceding EAR. These results are in accordance with the literature in which it was proposed that a more severe EAR and LAR after EC are correlated,* but that a LAR after EC can occur without a preceding EAR. The early fall in PEFR after EC was found to be significantly greater than the late fall. This is in accordance with the findings in most studies in which a majority contends that the LAR is less prevalent and less severe than the EAR after EC and in contradiction with a minority that has found that the LAR is more severe.


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