Deterioration of asthma in a patient with diffuse panbronchiolitis (DPB) after macrolide therapy

J Asthma. 2010 May;47(4):486-8. doi: 10.3109/02770901003759444.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Asthma / complications
  • Asthma / diagnostic imaging
  • Asthma / physiopathology*
  • Bronchiolitis / complications
  • Bronchiolitis / diagnostic imaging
  • Bronchiolitis / drug therapy*
  • Clarithromycin / therapeutic use*
  • Female
  • Humans
  • Macrolides / therapeutic use*
  • Procaterol / therapeutic use
  • Respiratory Function Tests
  • Tomography, X-Ray Computed

Substances

  • Adrenal Cortex Hormones
  • Macrolides
  • Clarithromycin
  • Procaterol