A 15 year old boy comes to your office for follow up of his reactive airway disease. He describes his symptoms as daily and also experiencing nocturnal symptoms approximately 2x per week. Spirometry performed in your office reveal that his FEV1/ PEFR is 75% of his predicted value. These results classify
his severity of asthma as:
A. Severe persistent
B. Moderate persistent
C. Mild persistent
D. Mild intermittent
The correct answer is B. Moderate persistent.
Here’s why:
– Daily symptoms and nocturnal symptoms 2x per week indicate persistent asthma.
– FEV1/PEFR (Forced Expiratory Volume in 1 second/Peak Expiratory Flow Rate) of 75% of predicted value indicates moderate airflow limitation.
According to the National Asthma Education and Prevention Program (NAEPP) guidelines, asthma severity is classified as:
– Mild intermittent: Symptoms ≤ 2x/week, FEV1/PEFR ≥ 80%
– Mild persistent: Symptoms > 2x/week but ≤ 1x/day, FEV1/PEFR ≥ 80%
– Moderate persistent: Daily symptoms, nocturnal symptoms ≥ 2x/month, FEV1/PEFR = 60-79%
– Severe persistent: Continuous symptoms, nocturnal symptoms ≥ 2x/week, FEV1/PEFR < 60%
This patient’s symptoms and spirometry results fit the criteria for moderate persistent asthma.