ABSTRACT
COPD (Chronic Obstructive Pulmonary Disease) is a well know mimic of bronchial asthma, in adults and in practice, it is not uncommon to encounter misdiagnosis both ways. There are of course similarities between asthma and COPD. Both are chronic diseases with varying degrees of airway infl ammation and obstruction. They are associated with excess mucous production and bronchoconstriction, to different degrees. Treatment of both involves the use of bronchodilators. However asthma is almost always steroid responsive, on the other hand, steroids are indicated only in a subset of severe COPD, and in any case, the benefi ts are very modest. From the point of view of treatment and prognostication, it is often necessary to differentiate between the two conditions. The frequent questions that are raised are: are they different ends of the spectrum of the same diseases? Is the diagnostic tag really important and will it radically change management or is it just a matter of semantics? These questions have resulted in several interesting pro/con debates, in scientifi c meetings,1,2 and these debates will probably continue in the future. One big drawback is that most of the studies in asthma and COPD have stringent entry criteria excluding patients with overlapping features and hence therapeutic interventions are not tested in this subgroup.
