Introduction:Asthma affects 5-10% of children and accurate diagnosis is crucial for proper treatment.Guidelines recommend a thorough evaluation to define asthma,as misdiagnosis can lead to uncontrolled symptoms and comorbidities.Misdiagnosis rates in school-age children range from 45-53.5%.

Aims:We aimed to compare the clinical characteristics of patients,referred to our clinic with asthma but subsequently diagnosed with a disease other than asthma, with confirmed asthma.

Methods:A total of 344 patients referred to the pediatric pulmonology clinic with a preliminary diagnosis of asthma in the last two years were retrospectively analyzed.

Results: The diagnosis of asthma was confirmed in 240(69.8%) of the patients, while 104(30.2%) of them diagnosed non-asthma.The most common diagnoses in non-asthma group were bronchiectasis(16.3%). All 22 patients under the age of 2 were diagnosed other than asthma.While the mean age was significantly higher in the asthma group, the gender distribution was similar.Clubbing, thorax deformity,growth retardation were high in the non-asthmatic group (p<0.001,p=0.031,p<0.001,respectively). Eosinophilia,high total IgE level,Asthma Predictive Index(API) positivity were significantly higher in the asthma group (p<0.001,p<0.001,p=0.01, respectively). FVC z-score was constantly low in the non-asthmatic group(p=0.042).

Conclusions:We realized that 1/3 of patients referred with asthma were misdiagnosed.Since history and physical exams are crucial,eosinophilia,IgE levels, and API are helpful tools in differential diagnosis.Misdiagnosis may delay main disease?s therapy,lead to comorbidities.Over-diagnosis asthma may miss other lung diseases.