Nelson Textbook of Pediatrics 22nd Edition | Acute onset of asthma-like symptoms after single high-level exposure to an irritant gas, fume, or vapor (chlorine, smoke, ammonia, acetic acid, diisocyanates). Onset within minutes to 24 hours, symptoms persist for ≥3 months. Non-immunologic, no prior sensitization required. Diagnosis: history of exposure + bronchial hyperresponsiveness (methacholine). Treatment: supportive care, bronchodilators, inhaled corticosteroids, systemic corticosteroids for severe cases. Prognosis: symptoms persist in many, may improve over years.
🌐 paeds.online — Pakistan's Pediatric Platform| Type | Exposure | Pathophysiology | Treatment |
|---|---|---|---|
| Acute RADS | Single high-level irritant (chlorine, smoke, ammonia, acids, diisocyanates) | Direct airway epithelial injury → desquamation, inflammation, fibrosis → bronchial hyperresponsiveness | Supportive care, bronchodilators, ICS, systemic steroids for severe, remove from exposure |
| Subacute irritant-induced asthma | Multiple lower-level exposures over weeks/months (World Trade Center rescue workers) | Chronic inflammation, airway remodeling | Same as RADS, plus exposure reduction |