Asthma bronchiale is the most common chronic disease of elite athletes, aggravated by inhalation of dust, dry and cold air, pollen, ozone or chlorinated swimming pool water and dehydration of mucous membranes. Diagnosis of asthma is difficult in athletes due to significantly better spirometric values as a result of increased physical exercise, extreme stress that may provoke asthmatic symptoms cannot be reproduced under laboratory conditions and often their symptoms are underestimated. Introduction of pharmacological therapy must also comply with WADA (World Anti-Doping Agency) guidelines. Our study included top athletes referred to the special sport lung outpatient clinic of the Department of Pulmonology in 2019 because of reduced exercise capacity after cardiovascular causes were excluded. In all these cases, detailed medical history and complex lung function tests were performed. Total of 27 athletes (23 men, 4 women) were analyzed, the mean age was 25.1±5.7 years. Majority were swimmers (n=17; 62.9%), but others also came from sports (water polo, rowing, canoeing, basketball, football, wrestling, fencing). Eleven of them had asthma since childhood, while 10 were diagnosed with asthma at our unit. In 5 patients, cause of symptoms was specified as intermittent laryngeal obstruction and postnasal drip. Two athletes were advised to use inhaled corticosteroids (ICS)+short-acting beta2-agonist, and 20 athletes received ICS+long-acting beta2-agonist treatment within the dose restrictions of WADA, using a single inhaler maintenance and reliever therapy. Diagnosis of asthma in elite athletes is challenging, however expert center guided therapy can significantly improve individual performance with strict adherence to WADA rules.
© Copyright 2020 European Respiratory Journal. European Respiratory Society. Alle Rechte vorbehalten.