RESOLUTION OF PEDIATRIC NOCTURNAL RESPIRATORY DISTRESS DUE TO UNDIAGNOSED ASTHMA: A CASE REPORT
Keywords:
Pediatric asthma, nocturnal symptoms, polygraphy, spirometry, inhaled corticosteroids, sleep disturbanceAbstract
Introduction: Sleep disturbances in children may result from a range of medical or behavioral causes, with asthma often overlooked when symptoms are limited to nighttime. Asthma with atypical presentation, manifesting predominantly as nocturnal respiratory symptoms, is common but frequently misdiagnosed due to absence of daytime symptoms.
Case Report: A 10-year-old boy presented with a two-year history of nightly dry cough, dyspneic episodes, and distress. ENT evaluation revealed allergic rhinitis, and allergen testing confirmed sensitization to environmental allergens. Despite treatment with nasal corticosteroids and antihistamines, symptoms persisted. Overnight polygraphy showed significant nocturnal hypoxemia. Spirometry with bronchodilator testing confirmed reversible airway obstruction. Initiation of inhaled corticosteroid therapy led to complete and sustained resolution of symptoms.
Conclusions: This case illustrates how asthma with atypical presentation can mimic primary sleep disorders. Comprehensive respiratory evaluation, including spirometry, is essential for accurate diagnosis. Early initiation of inhaled therapy can result in rapid clinical improvement and reduce unnecessary investigations.
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Copyright (c) 2025 Adrijana Ugrinoska Pandeva, Vesna Dzambazovska , Katerina Boshkovska
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