TY - JOUR T1 - Characteristics and impact of exercise-induced laryngeal obstruction: an international perspective JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00195-2021 SP - 00195-2021 AU - Emil S. Walsted AU - Bamidele Famokunwa AU - Louise Andersen AU - Sune L. Rubak AU - Frederik Buchvald AU - Lars Pedersen AU - James Dodd AU - Vibeke Backer AU - Kim G. Nielsen AU - Andrew Getzin AU - James H. Hull Y1 - 2021/01/01 UR - http://openres.ersjournals.com/content/early/2021/04/15/23120541.00195-2021.abstract N2 - Background Exercise-induced laryngeal obstruction (EILO) is a common cause of exertional breathlessness and wheeze yet frequently misdiagnosed as asthma. Insight regarding the demographic characteristics, laryngeal abnormalities and impact of EILO are currently limited, with data only available from individual centre reports. The aim of this work was to provide a broader perspective from a collaboration between multiple international expert centres.Methods Five geographically distinct clinical paediatric and adult centres (3 Denmark, 1 UK, 1 US) with an expertise in assessing unexplained exertional breathlessness completed database entry of key characteristic features for all cases referred with suspected EILO, over a 5-year period. All included cases completed clinical asthma work-up and continuous laryngoscopy during exercise (CLE) testing for EILO.Results Data were available for 1007 individuals (n=713 female (71%)), median (range) age of 24 (8–76) years and of these 586 (58%) were diagnosed with EILO. In all centres, EILO was frequently misdiagnosed as asthma; on average there was a 2-year delay to diagnosis of EILO and current asthma medication was discontinued in 20%. Collapse at the supraglottic level was seen in 60% whereas vocal cord dysfunction (VCD) was only detected/visualised in 18%. Nearly half (45%) of individuals with EILO were active participants in recreational level sports, suggesting that EILO is not simply confined to competitive/elite athletes.Conclusion Our findings outline key clinical characteristics and the impact of EILO/VCD similar in globally distinct regions, facilitating improved awareness of this condition to enhance recognition and avoid erroneous asthma treatment.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Walsted has nothing to disclose.Conflict of interest: Dr. Famokunwa has nothing to disclose.Conflict of interest: Dr. Andersen has nothing to disclose.Conflict of interest: Dr. Rubak has nothing to disclose.Conflict of interest: Dr. Buchvald has nothing to disclose.Conflict of interest: Dr. Pedersen has nothing to disclose.Conflict of interest: Dr. Dodd has nothing to disclose.Conflict of interest: Dr. Backer has nothing to disclose.Conflict of interest: Dr. Nielsen has nothing to disclose.Conflict of interest: Dr. Getzin has nothing to disclose.Conflict of interest: Dr. HULL has nothing to disclose. ER -