Abstract
Reactive airways dysfunction syndrome (RADS) is an asthma-like illness that develops after a single high-level exposure to a pulmonary irritant. Two different cases are reviewed, in which the exposure circumstances were not sufficient to result in adverse health effects yet resulted in persistent respiratory symptoms and a clinical diagnosis of RADS. Potential explanations for an erroneous diagnosis of RADS included an incomplete exposure assessment, medication adverse effects that can contribute to respiratory symptoms, and alternative explanations for respiratory symptoms or test findings. In particular, the empirical use of bronchodilator medications without a clear indication appeared to contribute to continued respiratory symptoms. Without a clear understanding of the patient's exposure, a RADS diagnosis should be carefully considered. The possibility of an iatrogenic sequence of events in which medication adverse effects facilitate respiratory symptoms and a mistaken RADS diagnosis should be considered, particularly in patients who have a poorly defined exposure history.
- reactive airways dysfunction syndrome
- RADS
- albuterol
- bronchodilator
- gastroesophageal reflux
- hydrogen sulfide
- hydrochloric acid
- iatrogenic
Footnotes
- Correspondence: David J Hewitt MD MPH, Center for Toxicology and Environmental Health, 5120 North Shore Drive, North Little Rock AR 72218. E-mail: dhewitt{at}cteh.com.
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Dr Hewitt received compensation for professional review of the described cases. He has disclosed no conflicts of interest.
- Copyright © 2011 by Daedalus Enterprises Inc.