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Astma hos barn ≥12 år och vuxna

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Definition:
En heterogen sjukdom som kännetecknas av en variabel luftvägsobstruktion som yttrar sig som återkommande, varierande luftvägssymtom såsom pip i bröstet, andnöd, trånghetskänsla i bröstet, hosta som varierar över tid.
Förekomst:
Prevalensen av astma är ungefär 10 %. Incidensen är högst under barndomen. Cirka 5–10 % av patienterna har svår astma.
Anamnes:
I anamnesen är ärftlighet och uppgifter om utlösande faktorer viktiga delar. 
Symtom:
Pip i bröstet, andnöd, trånghetskänsla i bröstet, hosta och allergiska symtom är vanligt förekommande symtom.
Kliniska fynd:
Oftast inga särskilda fynd vid välkontrollerad sjukdom. Spridda, högfrekventa pipljud med olika tonhöjd och längd, nedsatt saturation och tecken på allergi kan förekomma under försämringar av astma – akut astma .
Diagnostik:
Astma är en klinisk diagnos men dynamisk spirometri  är en viktig del av diagnostiken. Fynd av reversibel obstruktion stödjer diagnosen. PEF-mätningar  kan också användas.
Behandling:
Behandling består av icke-farmakologiska åtgärder såsom patientutbildning, undvikande av utlösande faktorer och rökavvänjning samt farmakologiska åtgärder med antiinflammatoriska och ibland luftrörsvidgande läkemedel.
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  • Hanna Sandelowsky, specialist i allmänmedicin, Capio Ringen Vårdcentral, Stockholm; Med dr, Karolinska Institutet, Stockholm

Tidigare sakkunniga

  • Leif Bjermer, professor och överläkare, Lung- och allergikliniken, Skånes universitetssjukhus