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Laryngeal spasm mimicking asthma and vitamin d deficiency
- Source :
- Allergy, Asthma & Immunology Research
- Publication Year :
- 2014
-
Abstract
- We present a woman with heterozygous carnitine palmitoyl transferase 2 (CPT-2) deficiency who in the last 6 months suffered from episodic dyspnea and choking. Symptoms could not be attributed to her muscular energy defect, since heterozygous CPT-2 deficiency is usually asymptomatic or causes only mild muscle fatigability. Myopathy is usually triggered by concurrent factors, either genetic (additional muscle enzymes defects) or acquired (metabolic stress). The patient was referred to our respiratory clinic for suspect bronchial asthma. Spirometry showed mild decrease in inspiratory flows. Methacholine challenge was negative. Dyspnea was triggered by hyperventilation-induced hypocapnia, which produced marked decrease in airflow rates, particularly in inspiratory flows, consistent with laryngospasm. Nutritional assessment of the patient showed low serum level of calcium and vitamin D, attributable to avoidance of milk and dairy products for lactose intolerance and to insufficient sunlight exposure. After calcium and vitamin D supplementation episodic laryngospasm disappeared and hypocapnic hyperventilation test induced very mild change in airflow rates. Calcium and vitamin D deficiency may favour laryngeal spasm mimicking asthma, particularly in subjects with underlying myopathy.
- Subjects :
- Pulmonary and Respiratory Medicine
Spirometry
medicine.medical_specialty
Laryngeal spasm
vitamin D deficiency
Immunology
Case Report
Gastroenterology
calcium deficiency
Hypocapnia
Internal medicine
Hyperventilation
Vitamin D and neurology
Immunology and Allergy
Medicine
Laryngospasm
Carnitine
Myopathy
medicine.diagnostic_test
business.industry
asthma
medicine.disease
Surgery
medicine.symptom
business
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Allergy, Asthma & Immunology Research
- Accession number :
- edsair.doi.dedup.....884359f9a70340c9aeb2a56bf7f0b53c