I have posted a question on this a while ago. I see a fair number (just saw one today) of older patients (usually women) who have never smoked, have normal gas exchange and chest radiography but who present with moderately severe degrees of fixed obstructive lung disease. They never have any history of asthma, cough or wheezing and their only complaint is DOE.
Usually there is some small-airway obstruction on the expiratory images of a HRCT but no other structural abnormalities.
Have you seen much of that? How do you label these patients? Unsuspected asthma with remodelling?
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One group of patients that can present in this manner are those with significant biofuel exposure. For example east indian women that cook indoors and inhale smoke all day - What is the culture/ethnicity of your patient?
Good article, this article make some interesting points.
airway data
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