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Late-Onset Asthma

Doctors diagnose late-onset asthma when an adult develops chronic coughing and wheezing, that does not appear to be caused by allergy, irritants or an obvious infection. Researchers at the University of Virginia at Charlottesville report that they can control late-onset asthma with medicines that kill fungi (1).

Until this report, the only effective treatment for non-allergic people who develop asthma after puberty are cortisones that have horrible side effects, such as osteoporosis, high blood pressure, obesity amd so forth. So the vast majority of people with late-onset asthma are treated with inhalers that contain cortisones and when that doesn't work, they are given cortisones that can be taken by mouth.

A previous study at National Jewish Hospital in Denver shows that many late-onset asthmatics are infected with an intracellular bacteria called mycoplasma (2,3) and studies at the University of Wisconsin and others (4,5,6) show that some get better when they are treated with the antibiotics, doxycycline, minocycline, Zithromax or Biaxin, but their symptoms often return when they stop taking antibiotics).

Asthma may be caused by infections with viruses and fungi, as well as by baceria. This study from the University of Virginia shows that some late-onset asthmatics can be controlled by taking medication, such as fluconazole, to kill fungi, but the symptoms often return when they stop taking the medication. Another study, from the Mayo Clinic, showed that 96 percent of people who develop late onset asthma and chronic sinus infections are infected with fungi (7). More on Late-Onset Asthma.

1)GW Ward, JA Woodfolk, ML Hayden, S Jackson, TAE PlattsMills. Treatment of late-onset asthma with fluconazole.Journal of Allergy and Clinical Immunology, 1999, Vol 104, Iss 3, Part 1, pp 541-546.

2). M Kraft, GH Cassell, JE Henson, H Watson, J Williamson, BP Marmion, CA Gaydos, RJ Martin. Detection of Mycoplasma pneumoniae in the airways of adults with chronic asthma. American Journal of Respiratory and Critical Care Medicine 158: 3 (SEP 1998):998-1001.

3) JAMA, 1997 (December 17);278(23):2051-2.

4) Annals of Allergy, Asthma and Immunology 1998(Jan);80(1):45-49.

5) Hahn DL. Treatment of chlamydia pneumoniae infection in adult asthma: A before -after trial. J Fam Pract. 1995;41:345-351.

6) JD Klausner, D Passaro, J Rosenberg, WL Thacker, DF Talkington, SB Werner, DJ Vugia. Enhanced control of an outbreak of Mycoplasma pneumoniae pneumonia with azithromycin prophylaxis. Journal of Infectious Diseases 177: 1 (JAN 1998):161-166.

7)A Homberger et al. The diagnosis and incidence of allergic fungal Sinusitis. Mayo Clinic Proceedings 1999(Sept);73(9):877-884.

Checked 10/1/14

June 1st, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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