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Related Experiment Videos

Brittle asthma.

Jon G Ayres1, Deepti Jyothish, Titus Ninan

  • 1Department of Environmental and Occupational Medicine, University of Aberdeen, Foresterhill Road, Aberdeen AB25 2ZP, UK.

Paediatric Respiratory Reviews
|June 30, 2004
PubMed
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Brittle asthma, a severe asthma phenotype, presents distinct challenges in adults and potentially children. Management requires a holistic approach, balancing steroid therapy with careful consideration of side effects.

Area of Science:

  • Pulmonology
  • Allergy and Immunology
  • Clinical Medicine

Background:

  • Asthma is a heterogeneous disease, with brittle asthma recognized as a distinct phenotype.
  • Two types of brittle asthma in adults include Type 1 (high PEF variability) and Type 2 (acute attacks with good baseline control).
  • The incidence and specific characteristics of brittle asthma in children are less understood but likely mirror adult challenges.

Purpose of the Study:

  • To highlight brittle asthma as a distinct and severe phenotype within the broader spectrum of asthma.
  • To discuss the characteristics, risks, and management strategies for brittle asthma in adults and children.
  • To emphasize the need for a holistic management approach for patients with this complex condition.

Main Methods:

  • Review and synthesis of existing knowledge on brittle asthma phenotypes in adults.

Related Experiment Videos

  • Discussion of clinical presentation, including diurnal peak expiratory flow (PEF) variability and acute exacerbations.
  • Consideration of associated factors such as atopy and psychosocial morbidity.

    • Main Results:

    • Brittle asthma, in both identified types, is associated with increased risk of mortality and significant morbidity.
    • Adults with brittle asthma often exhibit atopy and considerable psychosocial issues.
    • While not as extensively recognized in children, similar presentations and management difficulties are presumed.

    Conclusions:

    • Effective management of brittle asthma necessitates a holistic strategy, addressing causal factors, ensuring patient compliance, and providing education.
    • Steroid therapy (inhaled and oral) is central but requires careful balancing of benefits against potential side effects.
    • Continuous subcutaneous terbutaline may help control PEF variability but requires cautious use due to potential side effects.