“Asthma–COPD Overlap (ACO)” as descriptive term was used to define these patients. Although, Chronic Obstructive Pulmonary Disease (COPD) and asthma are different entities but, in some patients, they can share features of both the diseases. Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases. It is defined by the history of respiratory symptoms such as wheeze, shortness of breath, chest tightness, and cough that vary over time and in intensity, together with variable expiratory airflow limitation. Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. The global burdens of asthma and Chronic Obstructive Pulmonary Disease (COPD) are increasing, each of which was estimated to affect respectively approximate 339 million and 251 million people worldwide in 2016. In our case, patient was diagnosed with ACO, based on the spirometry findings and the sputum findings have helped in the modification of his treatment and causing alleviations of symptoms and better clinical outcome. We highlight the importance of identification of Asthma COPD overlap as different phenotype from COPD or asthma alone as it is challenging to diagnose ACO in India. There is scarcity of literature available in country like India. The criteria to diagnose asthma-COPD overlap (ACO) include positive bronchodilator response, sputum eosinophilia or previous diagnosis of asthma, high IgE and/or history of atopy. He was diagnosed with COPD 6 years back as patient has history of biomass fuel exposure since childhood. We report a case of 61year-old-male who presented with nocturnal and early morning breathlessness, cough and wheezing episodes for past 2-3 weeks. Inhalational steroids provide significant alleviation of symptoms in such patients and some studies suggest that the most severe patients may respond to biological agents indicated for severe asthma. Such patients experience frequent exacerbations, poor quality of life, rapid decline in lung function and high mortality than COPD alone. In patients with a primary diagnosis of COPD, the identification of ACO has got implication for better prognosis and treatment. The co-existence of asthma-chronic obstructive pulmonary disease overlap (ACO) in Chronic Obstructive Pulmonary Disease (COPD) patients is often unrecognized. As we know that, Asthma and chronic obstructive pulmonary diseases are well characterized diseases, they can co-exist as asthma-COPD overlap (ACO).
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