Our Mission

The Nebraska Asthma Coalition strives to improve health outcomes and quality of life for individuals affected by asthma in our state. We work to accomplish our mission through our core values of collaboration, inclusivity, data-driven decision making and commitment to addressing health disparities. 

Asthma Mimickers

Jen Luedders, M.D. 

Assistant Professor, Division of Allergy and Immunology, UNMC

Asthma often presents with symptoms of cough, wheeze, shortness of breath, and difficulty breathing. However, there are other conditions which can cause similar symptoms and may be misdiagnosed as asthma. Both over- and underdiagnosis of asthma can pose problems for patients and clinicians. Prior estimates suggest about 33% of adults and children who have been diagnosed with asthma do not truly have current asthma.1 Therefore, it is important to increase awareness about other conditions that can cause similar symptoms.

A disorder called inducible laryngeal obstruction, previously known as vocal cord dysfunction, is commonly misdiagnosed as asthma. Symptoms that should prompt consideration of this diagnosis are respiratory symptoms triggered by strong odors or irritants, associated symptoms of throat tightness or voice changes, and symptoms associated more with breathing in than breathing out.2 Another diagnosis that mimics asthma is panic attacks. Symptoms that should prompt consideration of this diagnosis over asthma are associations with dizziness or lightheadedness and symptoms triggered by anxiety.3

Additionally, chronic upper airway cough syndrome is a frequent asthma mimicker. This disorder involves post-nasal drip that exacerbates coughing symptoms. Symptoms that should prompt consideration of this diagnosis are sneezing, itchy nose or eyes, and frequent throat clearing.3 Primary lung diseases, such as chronic obstructive pulmonary disease (COPD) or bronchiectasis, can also appear similar to asthma. New onset respiratory symptoms over the age of 40 years, history of prior tobacco use, and history of recurrent lung infections should prompt consideration of COPD.3 Similarly, recurrent lung infections or productive cough could be signs of bronchiectasis as the underlying problem.3

It is important to have confirmation of asthma with appropriate studies and evaluation by an informed clinician. Accurate diagnosis is critical to improving patient outcomes and improving quality of life for those both with and without asthma.

References

1.    Aaron SD, Boulet LP, Reddel HK, Gershon AS. Underdiagnosis and Overdiagnosis of Asthma. Am J Respir Crit Care Med. 2018 Oct 15;198(8):1012-1020. doi: 10.1164/rccm.201804-0682CI. PMID: 29756989.

2.    Stojanovic S, Sverrild A, Tay TR, Denton E, Murthee KG, Lin T, Gardner L, Wong M, Borg B, Mahoney J, Lee J, Hew M. Mannitol provocation enhances laryngoscopic diagnosis of suspected inducible laryngeal obstruction. Ann Allergy Asthma Immunol. 2025 Feb 8:S1081-1206(25)00069-9. doi: 10.1016/j.anai.2025.02.001. Epub ahead of print. PMID: 39929392.

3.    Reddel HK. Common conditions that mimic asthma. Med J Aust. 2022 Apr 18;216(7):337-340. doi: 10.5694/mja2.51467. Epub 2022 Mar 28. PMID: 35342957; PMCID: PMC9313614.

Mary Lanning Sponsorship