Abstract

The classification of airway disease is in a mess. When I was a medical student and dinosaurs walked the earth, there were four conditions: childhood asthma, late-onset asthma, chronic bronchitis, and emphysema. The latter two were then amalgamated, for reasons I still do not understand, into COPD, and defined on the basis of fixed airflow obstruction on spirometry. The two forms of asthma had similarities in that they had variable airflow obstruction and were steroid responsive. Childhood asthma was characterised by atopy, family history, and associated conditions such as eczema and rhinitis. Late-onset asthma rarely had these associations.