Table 1

Asthma differentials and clues in medical history

Differential diagnosisPossible features of history
Cystic fibrosis49 64
  • Symptoms present from birth.

  • Finger clubbing.

  • Family history of cystic fibrosis or unexplained/atypical respiratory disease.

  • Weight faltering.

  • Gastrointestinal symptoms.

Primary ciliary dyskinesia64
  • Symptoms present from birth.

  • Family history of unexplained respiratory symptoms.

  • Persistent cough.

  • Nasal symptoms.

Chronic lung disease of prematurity/bronchopulmonary dysplasia64
  • Premature.

Bronchiectasis49 64
  • Persistent productive cough.

  • Finger clubbing.

Laryngeal dysfunction64
  • Stridor.

  • Abnormal cry.

Gastro-oesophageal reflux disease or aspiration49
  • Vomiting.

  • Weight faltering.

  • Recurrent infections.

Structural abnormality, for example, bronchomalacia and bronchogenic cyst65
  • Present from birth.

  • No variation to wheeze.

  • Weight faltering.

  • Recurrent and/or atypical infections.

Foreign body aspiration65
  • Sudden onset.

  • Unilateral chest features.