Setty Niranjan, Crawford Alice, Kyle Brooke, Thakkar Dhaval, Thomas Rajesh, Blakey John
Department of Respiratory Medicine Sir Charles Gairdner Hospital Perth West Australia Australia.
School of Medical and Health Sciences Edith Cowan university Perth Western Australia Australia.
Respirol Case Rep. 2024 Dec 8;12(12):e70083. doi: 10.1002/rcr2.70083. eCollection 2024 Dec.
Asthma is a highly prevalent but heterogenous condition. Uncontrolled disease is relatively common and may be due to ongoing inflammation and/or persisting bronchial hyper-reactivity. Bronchial thermoplasty has been in use for many years but optimal case selection and post-procedure assessment remain uncertain. We present a case of a gentleman in his 50s with lifelong asthma who experienced a persistent loss of control following influenza A in 2017. Despite multidisciplinary assessment and guideline-based escalation of therapy, he had persisting symptoms. In the context of his atopy, he was trialled unsuccessfully on dupilumab. Bronchial thermoplasty (BT) was undertaken with good clinical benefit. Although his spirometry was little changed by BT, there was improvement in forced oscillometry technique (FOT) measurements. FOT may therefore be a useful addition to the assessment and monitoring of individuals considered for, or undergoing, BT.
哮喘是一种高度流行但异质性的疾病。未得到控制的疾病相对常见,可能是由于持续的炎症和/或持续的支气管高反应性所致。支气管热成形术已应用多年,但最佳病例选择和术后评估仍不明确。我们报告一例50多岁患有终身哮喘的男性病例,他在2017年感染甲型流感后经历了持续的病情失控。尽管进行了多学科评估并根据指南逐步加强治疗,但他仍有持续症状。鉴于他的特应性体质,他试用度普利尤单抗未成功。进行支气管热成形术(BT)后临床获益良好。虽然BT对他的肺量计检查结果改变不大,但强迫振荡技术(FOT)测量有所改善。因此,FOT可能是评估和监测考虑进行或正在接受BT治疗的个体的有用补充。