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Editorials |

Streamlining Methacholine Challenge Testing

Yancy Y. Phillips, MD, FCCP; Robert D. Schreiner, MD, FCCP
Author and Funding Information

Atlanta, GA 


Correspondence to: Yancy Phillips, MD, FCCP, The Southeast Permanente Medical Group, Nine Piedmont Center, 3495 Piedmont Rd, NE, Atlanta, GA 30305



Chest. 2001;120(6):1763-1765. doi:10.1378/chest.120.6.1763
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The diagnosis of asthma is usually made after careful consideration of a patient’s individual history and the demonstration of reversible airway obstruction. Those are the easy ones. For many patients with some combination of cough, wheezing, dyspnea, and chest tightness, the diagnosis may remain unclear after initial history, physical examination, and spirometry. In such cases, the methacholine challenge test (MCT) has become the most widely used method of evaluating the likelihood that a given patient’s respiratory symptoms represent asthma. Making a diagnosis of asthma with confidence should lead to appropriate therapy. Refuting the diagnosis can lead to a broadened differential diagnosis that includes less common disorders with similar nonspecific symptoms whose diagnosis is often greatly delayed, such as endobronchial lesions, interstitial lung disease, or pulmonary vascular disease.

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