Difference between Asthma and Bronchiolitis

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Asthma and Bronchiolitis are the most common pulmonary diseases causing wheezing in children; However, Coughing and wheezing in bronchiolitis is difficult to distinguish from asthma, as both disorders have similar symptoms and signs.

Asthma and Bronchiolitis are common inflammatory respiratory diseases in children that primarily involve the alveoli, perialveolar, and bronchial tissues, often leading to a classic triad of symptoms characterized by wheezing, shallow breathing and gagging, which are specific symptoms to obstructive lung disease, and to wet infections of the bronchial and alveolar tree.

The differentiation between bronchiolitis, and asthma, in the early stage of disease is extremely important to adopt a proper treatment; However, it can be difficult to distinguish between them because of the high prevalence of these diseases in early childhood and the common clinical picture and pathophysiological pathways. Its always hard to find the difference between asthma and bronchiolitis, as the majority of patients are children often presenting with similar symptoms, and because children cannot tell exactly what they are feeling or suffering of. The objective of this review is to highlight the differences between these diseases in terms of the symptoms, and diagnosis.[1][4]

Diagnosis is often challenging, because the majority of signs and symptoms are nonspecific; However, a proper diagnosis is best for successful treatment, because the medications used to treat bronchiolitis and the anti-asthmatic drugs are distinctive, so treatment is only possible after getting a correct diagnosis.

If your kid is having breathing problems with ongoing inflammation, immediately call a nearby hospital for advice and evaluation, or just dial 911 for assistance.

Criterias to aid in the differential diagnosis of Asthma and Bronchiolitis

• Age

Asthma affects children older than 2 years, as it effects only the bronchi and bronchioles, not the alveoli, whereas bronchiolitis commonly affect children aged less than 2 years.

Asthma affects about 7 million American children between the ages of 5 and 14.[11]

• Temperature

Asthma does not cause a fever, whereas bronchiolitis, which is usually caused by a viral infection, typically presents with low-grade fever.[10]

• Allergies

Allergic asthma is the most common type of asthma; Moreover, About 90% of kids with asthma have allergies and commonly show symptoms before they turn 5. Whereas children suffering of bronchiolitis, which is a pulmonary infectious disease that most children will get by the time they are two, are less likely to develop allergic reactions. [2][3][8]

• Family History

Asthma is an allergic disease that is caused by a complex relationship between genetic predisposition and environmental factors; However,  Asthma can happen to anyone without any risk factors, though it is believed to run strongly in families, whereas Bronchiolitis does not run in families. [5][6][7]

• Reaction to Medicine

Asthma can be controlled by pharmaceuticals. Epipen and Antihistamines are commonly used for treating asthma, and drugs such as EpiPen Auto Injectors are used to treat severe allergic reactions; However, Acute bronchiolitis is usually caused by viruses and no Epinephrine nor Antihistamines can help.[12][13]

 

 

 

References

1. emc.healthyorthodoxmedicine.com
2. webmd.com/asthma/guide/allergic-asthma
3. aaaai.org/conditions-and-treatments/library/at-a-glance/childhood-asthma
4. ncbi.nlm.nih.gov/pmc/articles/PMC3488995/
5. who.int/genomics/about/Asthma.pdf
6. ncbi.nlm.nih.gov/pmc/articles/PMC3151648/
7. ncbi.nlm.nih.gov/pubmed/10353570
8. jbc.org/content/286/38/32883.full
9. hmg.oxfordjournals.org/content/9/16/2359.full
10. aafp.org/afp/1998/0315/p1270.html
11. cdc.gov/asthma/impacts_nation/asthmafactsheet.pdf
12. abcnews.go.com/Health/patients-epipens-asthma-inhalers-incorrectly-researchers-find/story?id=27690143
13. drugs.com/epipen-auto-injector.html

Differential diagnosis of Asthma and Bronchiolitis

Verified by: Dr.Diab (January 18, 2017)

Citation: Dr.Diab. (January 18, 2017). Differential diagnosis of Asthma and Bronchiolitis. Medcoi Journal of Medicine, 16(2). urn:medcoi:article2900.