TY - JOUR T1 - Breathless athlete: exercise-induced laryngeal obstruction JF - British Journal of Sports Medicine JO - Br J Sports Med SP - 1211 LP - 1212 DO - 10.1136/bjsports-2018-099159 VL - 52 IS - 18 AU - Steffan Arthur Griffin AU - Emil S Walsted AU - James H Hull Y1 - 2018/09/01 UR - http://bjsm.bmj.com/content/52/18/1211.abstract N2 - Exercise-induced laryngeal obstruction (EILO) describes a condition in which the voice box closes inappropriately during vigorous exercise to precipitate respiratory symptoms, such as cough, wheeze and breathlessness.1 This can occur secondary to adduction of the vocal cords (glottic mechanism)±collapse of the arytenoid or aryepiglottic mucosa (supraglottic mechanism) with complete or incomplete obstruction of the larynx. The condition is highly prevalent in young athletes and estimated to affect between 5% and 10% of all adolescents.2 Despite this, EILO often remains overlooked as the cause of an athlete’s breathing difficulties and is often misdiagnosed as exercise-induced asthma.3 Failure to consider EILO in the differential diagnosis of a breathless athlete can result in delay to the initiation of effective treatment, and also to a potential inappropriate escalation in asthma therapy, with a deleterious impact on health and athletic performance. Research has shown that EILO may coexist with asthma, and distinguishing between these conditions can be challenging and often requires specialist investigation (figure 1). Figure 1 Comparing EILO to EIB.  EIB, exercise-induced bronchoconstriction; EILO, exercise-induced laryngeal obstruction.An 18-year-old female swimmer presents with a 3-year history of breathlessness that develops exclusively during high-intensity exercise. Inhaled asthma therapy, prescribed presumptively for a diagnosis … ER -