Table 1 Asthma-COPD overlap syndrome, definitions and diagnostic criteria
Gibson P, Simpson J [7], 2009 | Asthma and COPD (symptoms of increased variability of airflow and incompletely reversible airflow obstruction) |
COPD gene [5],2011 | Patients with COPD and a diagnosis of asthma before the age of 40 |
Spanish consensus [11], 2012 (patients must fulfill 2 major criteria or 1 major and 2 minor) | Major criteria |
Very positive bronchodilator response (>400 ml and >15 % in FEV1) | |
Sputum eosinophilia | |
Previous diagnosis of asthma | |
Minor criteria | |
Increased total serum IgE | |
Previous history of atopy | |
Positive bronchodilator test (>200 mL and >12 % in FEV1) on at least two occasions | |
Czech Republic guidelines [13], 2013 (patients must fulfill 2 major criteria or 1 major and 2 minor) | Major criteria |
Strong bronchodilator test positivity (FEV1 > 15 % and > 400 ml) | |
Positive bronchial challenge test | |
FeNO > 45–50 ppb and/or sputum eosinophilia ≥3 % | |
Histoy of asthma | |
Minor criteria | |
Mild bronchodilator test positivity (FEV1 > 12 % and > 200 ml) | |
Increased total IgE | |
History of atopy | |
Louie S et al. [8], 2013 | -Asthma with partially reversible airflow obstruction with/without emphysema or reduction of DLCO <80 % predicted. |
-COPD with emphysema accompanied by reversible or partially reversible airflow obstruction, with or without environmental allergies or reduced DLCO | |
Menezes M et al. [30], 2013 | FEV1/FVC <0.7 and medical diagnosis of asthma or wheezing + positive bronchodilator test (>200 mL and >12 % in FEV1) |
Izquierdo-Alonso et al. [9] (2013) | COPD (more than 10 pack-years and post bronchodilator FEV1/FVC < 0.7) |
History of asthma before the age of 40 | |
Normal carbon monoxide (CO) diffusion capacity and absence of pulmonary emphysema demonstrated by imaging techniques | |
GOLD-GINA document [15] (2014) | Persistent airflow limitation with several features usually associated with asthma and several features usually associated with COPD |
Finish guidelines [14] (2014) (patients must fulfill 2 main criteria or 1 main and 2 additional) | Main criteria |
Significant bronchodilatory effect (FEV1 > 15 % and > 400 ml) | |
Sputum eosinophilia or elevated ENO (>50 ppb) | |
Previous asthma symptoms (starting before the age of 40) | |
Additional criteria | |
Elevated total IgE | |
Atopy | |
Repeated significant bronchodilatory response (FEV1 > 12 % and >200 ml) | |
PEF-follow up typical of asthma |