Asthma-COPD-Overlap-Syndrom

Zusammenfassung

Symptomatische Patienten mit obstruktiver Ventilationsstörung bedürfen einer pneumologischen Differentialdiagnostik. Bei der überwiegenden Zahl der Patienten ist eine Zuordnung zu Asthma oder COPD ohne größere diagnostische Schwierigkeiten anhand der Symptome, Expositionsanamnese, Allergiediagnostik und erweiterten Lungenfunktionsprüfung möglich. Bei einem Teil der Patienten bleiben aber diagnostische Schwierigkeiten und die Zuordnung zu Asthma oder COPD ist nicht ohne weiteres möglich. Für solche Fälle wird das Asthma-COPD-Overlap-Syndrom (ACOS) vorgeschlagen. Für dieses Syndrom sind jedoch keine Daten aus größeren Observationsstudien mit einheitlich definierten Kriterien vorhanden, noch ist je eine prospektive Therapiestudie durchgeführt worden. Daher sollte zum gegenwärtigen Zeitpunkt zurückhaltend mit dem Begriff Asthma-COPD-Overlap-Syndrom umgegangen und die Patienten der primären Diagnose COPD oder Asthma zugeordnet werden.

Abstract

Symptomatic patients with airflow limitation need to have a diagnostic follow-up to distinguish chronic obstructive pulmonary disease (COPD) from asthma. In the majority of cases this can be easily done based on symptoms, exposition to e. g. allergens or cigarette smoke, measures of allergy, and extensive lung function testing. In a minority of patients, however, it is difficult to distinguish between asthma and COPD. The term „asthma-copd-overlap-syndrome“ has been proposed fur such cases. The current problem with this proposal is the lack of studies that all used the same criteria to better characterize this syndrome. Furthermore, there is not a single therapeutic-interventional study that would allow a firm conclusion regarding the proposed therapy. Therefore, the primary diagnosis should still be either COPD or asthma.

Schlüsselwörter

COPD - Asthma - Overlap-Syndrom

Keywords

COPD - asthma - overlap-Syndrome

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