Deterioration of asthma in a patient with diffuse panbronchiolitis (DPB) after macrolide therapy.
Diffuse panbronchiolitis (DPB), an important cause of progressive obstructive lung disease in the Far East, is a distinctive sinobronchial syndrome with characteristic radiologic and histologic features. Asthma is a chronic inflammatory disease characterized by airway narrowing. The major inflammatory cells involved in the pathogenesis of asthma are type 2 helper T (Th2) cells, eosinophils, and mast cells. The authors' patient was diagnosed with DPB and asthma. Although macrolide therapy led to the disappearance of the radiologic abnormalities indicating centrilobular nodular lesions, the respiratory symptoms and pulmonary function worsened. Administration of inhaled corticosteroids improved the respiratory symptoms and pulmonary function. To the authors' knowledge, no case of DPB with asthma has been reported in the English-language literature.
Matsuno
Osamu
O
Department of Respiratory Disease, Osaka Minami Medical Center, Osaka, Japan. matsuno@med.oita-u.ac.jp
Ueno
Kiyonobu
K
Hayama
Yoshitomo
Y
Honda
Hidehiro
H
Yamane
Hiroyuki
H
Saeki
Yukihiko
Y
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001249:Asthma / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001988:Bronchiolitis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D017291:Clarithromycin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D018942:Macrolides / Q000627:therapeutic use*; D017265:Procaterol / Q000627:therapeutic use; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed
D000305:Adrenal Cortex Hormones; D018942:Macrolides; D017291:Clarithromycin; D017265:Procaterol