Difficult asthma: consider all of the possibilities.
Asthma is a common respiratory disease that can often be managed successfully. However, there are patients that do not respond to the maximum doses of standard therapy and subsequently have a reduced quality of life. Many factors can contribute to a failure to respond to treatment, and a comprehensive approach is important when assessing and evaluating these patients. This report describes a patient referred for 'difficult to control asthma' who had multiple emergency department visits and hospitalizations. In addition to a history of wheezing, spirometry showed impaired flow and vital capacity was reduced. Further investigation showed a normal total lung capacity, and a computed tomography scan revealed main bronchus blockage by a tumour, which was confirmed by bronchoscopy. This led to a surgical resection of a mucoepidermoid carcinoma. This case highlights the need to consider all possibilities during the evaluation of patients with difficult asthma.
Cicutto
L C
LC
Toronto Western Hospital, Toronto, Canada. lisa.cicutto@utoronto.ca
Chapman
K R
KR
Chamberlain
D
D
Downey
G P
GP
D000328:Adult; D001249:Asthma / Q000150:complications* / Q000503:physiopathology; D001984:Bronchial Neoplasms / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D018277:Carcinoma, Mucoepidermoid / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D012129:Respiratory Function Tests; D013147:Spirometry