Nota clínica: asma refractaria

Andrea Trisán Alonso, Aitor Asensi Jurado

Resumen


Se describe el caso de una paciente que había sido diagnosticada de asma grave mal controlada, pero en la que se confirmó el diagnóstico de disfunción de cuerdas vocales (DCV); y a continuación, se expone una revisión de la literatura sobre las características de esta entidad.

La DCV recientemente denominada obstrucción laríngea inducible (OLI),  se caracteriza por un movimiento anormal de la laringe normalmente durante la inspiración. De causa desconocida, puede desencadenarse por goteo postnasal, reflujo esófago-laríngeo , ejercicio, olores fuertes o humos, emociones fuertes o estrés. Su presentación suele ser brusca con una sensación de ahogo intenso, tos y estridor, por lo que frecuentemente se confunde con asma. El diagnóstico puede resultar difícil, sobre todo fuera del episodio agudo, siendo la prueba oro la confirmación del movimiento paradójico de las cuerdas vocales mediante fibrolaringoscopia.


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Referencias


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