Can Reactive Airways Dysfunction Syndrome (RADS) be iatrogenic?

Respir Care. 2011 Aug;56(8):1188-94. doi: 10.4187/respcare.01104. Epub 2011 Mar 30.

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.

Publication types

  • Case Reports

MeSH terms

  • Asthma / diagnosis
  • Asthma / etiology*
  • Asthma / physiopathology
  • Bronchodilator Agents / adverse effects*
  • Bronchodilator Agents / therapeutic use
  • Diagnosis, Differential
  • Humans
  • Iatrogenic Disease*
  • Male
  • Medication Errors / adverse effects*
  • Middle Aged
  • Occupational Diseases / chemically induced
  • Occupational Diseases / diagnosis
  • Occupational Diseases / drug therapy
  • Occupational Exposure / adverse effects
  • Respiratory Function Tests / methods*
  • Risk Factors
  • Syndrome

Substances

  • Bronchodilator Agents