R. T. ABBOUD, M.D., F.R.C.P.(C)
To the editor: I read with great interest the case report, "Reversible Restrictive Lung Disease Simulating Asthma" (Ann Intern Med 85:328-332, 1976). The authors suggest two possibilities to explain their findings: marked and variable respiratory muscle weakness or alveolar duct constriction; despite their detailed studies they could not differentiate between the two.
Their observation that maximum inspiratory recoil pressure was markedly decreased after exercise (Figure 3 of their paper) suggests that limitation of chest expansion rather than airway closure was the primary cause of the restriction. The authors could have ascertained whether inspiratory muscle weakness was the primary pathogenetic mechanism
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ABBOUD RT. Primary Defect in Restrictive Lung Disease. Ann Intern Med. 1977;86:242–243. doi: 10.7326/0003-4819-86-2-242
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Published: Ann Intern Med. 1977;86(2):242-243.
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