Functional symptoms confused with allergic disorders in children and adolescents

Abstract

The diagnosis of a functional respiratory disorder is sometimes difficult and time-consuming, because the symptoms often resemble those of organic diseases. The most common entities are hyperventilation syndrome, psychogenic cough, sighing dyspnea, and vocal cord dysfunction. Typical signs are heavy breathing or dyspnea, cough or sneezing, various breathing sounds, tightness of the throat or chest, pain, and fear. Criteria for differentiation include the lack of nocturnal symptoms, the sudden occurrence, no typical trigger factors, the variable duration, a quick regression, and that symptoms do not respond to adequate pharmacotherapy and finally normal results of diagnostic work-up. Therapeutic options comprise psychological intervention (by reassurance, relaxation techniques, and behaviour therapy) and physiotherapy (e.g. breathing therapy, voice training). Intensive efforts should be made to diagnose functional symptoms at an early stage because this will prevent stigmatization and fixation of symptoms and disease, and also prevent children from undergoing unnecessary and potentially harmful therapies.

Guidelines for Evaluating Chronic Cough in Pediatrics

“…160,161 Some have described 160,161 greater respiratory symptom chronicity, 162 while others have not. 167 74,90,165,166 Cough as a functional symptom can also be mistaken for an allergic disorder in children.…”

Respiratory Retraining Therapy in Long-Term Treatment of Paradoxical Vocal Fold Dysfunction

“…The most typical symptoms of this condition are: acute sudden dyspnea, chronic cough, shortness of breath, a sensation of pressure on the throat, choking and laryngeal wheezing during inspiration (wheezing not always present) [3,11,[31][32][33] . PVFD is often confused with asthma, idiopathic anaphylaxis, angioedema, reactive airway dysfunction syndrome, GERD, organic laryngeal lesions (cancer) and functional laryngeal disorders (laryngospasm) [34,35] . Besides its similarity with other clinical situations, PVFD is frequently associated with asthma, exercise-induced asthma and gastroesophageal reflux, so the paradoxical motion of the vocal folds during inspiration, which is responsible for the acute episode or dyspnea or chronic cough, often remains undiagnosed [23,31] .…”

A Teenage Girl with Extreme Tachypnea

“…Although functional respiratory disorders have been described decades ago, there is relatively little information written about them. 1 Many of these disorders can be diagnosed with a carefully taken history and a thorough physical examination. Our patient seemed to have extreme tachypnea without obvious dyspnea.…”