Friday, August 06, 2010 Angel asks

Q: Negative methacholine challenge test?

Hi,

So I was treated for asthma for 5 years, and then a pulmonologist sent me for a methacholine challenge test, which was negative. However I have a positive reversibility of 13 and 15% on two PFT tests. My allergist says I have moderate asthma and has seen me very sick, while all of the pulmonologists I've seen say I don't and berate me for "wanting to take so many steroids". I do have trouble breathing several periods of year that last for weeks, and it is affected seasonally and in reaction to triggers (like smoke). Is it possible to have asthma with a negative methacholine challenge test? Is there something else to call this?

I feel like a fraud taking so much medicine, but at the same time I can't breath without it.

Angel

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Answers (3)

Rick Frea, Health Pro

8/ 6/10 10:55pm

Here is a good post to review how asthma is diagnosed. As a general rule of thumb, a negative methacholine challenge should rule out asthma. However, the reversibility factor of 10-15% or better times two tests is also a sign that you do have asthma.

Perhaps the methacholine test was a false negative and should be repeated. This might be something to discuss with your pulmonoligist or allergist.

It may also be possible you have something other than asthma, perhaps another disease that is partially reversible with a bronchodilator, such as COPD. You can still get COPD if you have never smoked.

Your pulmonologist should be able to properly diagnose you in this regard so you can be treated properly and have some peace of mind.

It's never easy when your doctors have opposing opinions as to proper diagnosis. Usually in this case I'd recommend another opinion, although from what you describe here you've already seen more than one pulmonologist.

I wish I had an easy answer for you. I hope this helps. Good luck.

Angel

8/ 7/10 5:30pm

Hi,

Thanks for the information. It's taken a lot of time to sort this out, but I think that I will eventually get a treatment plan that helps. My plan right now is to take some inhalers (flovent and xopenex), which seem to keep me functioning, until I can go for one more opinion this Fall with a doctor I've spoken to who seems to know more about my problem, and the pulmonologist she works with. They seem to think I'm aspirating because my esophagus is compressed, which they say can cause asthma-like symtoms...

I hope that you don't mind answering one more question...over the last few years I've heard my doctors refer to Reactive Airways Disease. Could you please explain the difference between reactive airways and asthma?

Thanks,

Angel

Linda Joy Adams

8/26/10 5:21pm

My methacholine tests have always been positive since injured 21+ ago. My understanding after having several of them as a patients and reading and being informed by doctors is that it just 'induces' a reaction. Maybe you are reacting to something different than is in the solution? Which chemicals seem to be your triggers? Everyday, someone seems to have further problems with the system in getting diagnosed. For several years, the solutions wasn't even available in USA and the medcial facility had to get an import license to obtain it. This was done to penalize the manufacturer for something they had done involving another product. A lot of questions? can be asked? So often, when you have this, you've had a severe injury and probably have been forced into filing some kind of damage claim in order to get treatment. If this isn't your case, be thankful! Linda Joy Adams

sandy

12/22/10 9:18pm

i was tested for asthma approximately 30 hours after a short surgery and a nebulizer was used because of the chance that i could have asthma.

could this stay in my body and produce a false negative result?

Q: Negative methacholine challenge test?

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