PRONOUNCED BRONCHIAL HYPERRESPONSIVENESS AND ASTHMA SEVERITY

Fifty-six asthmatics from an asthma ward or from an asthma out-patient clinic were challenged with two low concentrations (0.03 and 0.012 mg ) of metacholine chloride in order to assess the relationship between pronounced hyper-responsiveness and asthma severity in a clinical sett ing. Only inhaled bronchodilators were stopped before challenge. Asthm a severity was assessed retrospectively and prospectively on the basis of treatment, number of days in hospital, intensive care, number of e mergency visits and days on sick-le ave. The results show that pronoun ced hyper-responsiveness (n=28) is not associated with asthma severity . It is concluded that a single simplified test of pronounced bronchia l hyper-responsiveness, performed without taking into consideration th e actual state of the disease and without stopping all medication, is of no help in identifying the patients with the clinically most severe asthma and worst prognosis.