Menstrual asthma: use of a gonadotropin-releasing hormone analogue for the treatment of cyclic aggravation of bronchial asthma.
A new clinical indication for GnRH-a treatment seems to exist in addition to the many indications known so far. The successful treatment of cyclic severe attacks of bronchial asthma during ovulation and the menstrual periods with a GnRH-a is described. A 45-year-old woman with long-standing bronchial asthma was hospitalized because of severe bronchial asthma and status asthmaticus 11 times during the 5 months before her referral. The hospitalizations were either during the ovulatory or menstrual period, and in two of them they were so grave to require artificial ventilation through an endotracheal tube. To induce pituitary-ovarian desensitization and amenorrhea, the patient was put on monthly injections of depot GnRH-a, which she has been receiving for the last 20 months. Subjective improvement was accompanied by a significant improvement in spirometric indices, by lack of hospitalizations, and decrease in glucocorticoid daily dosage. Although a trial of sequential add-back HRT was unsupportable because of respiratory aggravation, low-dose continuous HRT was tolerated by the patient. In light of the dramatic subjective and objective improvement in association with the GnRH-a treatment, we conclude that this new application deserves further experience.
Blumenfeld
Z
Z
Department of Obstetrics and Gynecology, Rambam Medical Center, B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa.
Bentur
L
L
Yoffe
N
N
Alroy
G
G
Rubin
A H
AH
D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology*; D005260:Female; D005541:Forced Expiratory Volume; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives*; D006801:Humans; D008597:Menstrual Cycle; D008875:Middle Aged; D017329:Triptorelin Pamoate / Q000627:therapeutic use*
D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone