Related Experiment Video
Updated: Jul 9, 2026
09:58
A Reversible, Non-invasive Method for Airway Resistance Measurements and Bronchoalveolar Lavage Fluid Sampling in Mice
Published on: April 13, 2010
Clinical differentiation between resistant asthma and chronic bronchiolitis: testing a practical approach
Mostafa Ghanei1, Henry D Tazelaar, Ali Harandi
1Research Center of Chemical Injuries, Baqiyatallah Medical Sciences University, Research Center of Chemical Injuries, Tehran, Iran. mghanei@excite.com
Iranian Journal of Allergy, Asthma, and Immunology
|December 21, 2007
Summary
Many patients with intractable asthma may actually have chronic bronchiolitis. Macrolide therapy showed significant improvement in symptoms and lung function for these misdiagnosed patients, suggesting further evaluation is warranted.
Area of Science:
- Pulmonology
- Respiratory Medicine
- Clinical Diagnosis
Background:
- Intractable asthma presents a significant clinical challenge.
- A subset of patients diagnosed with intractable asthma may be misdiagnosed with other respiratory conditions.
- Chronic bronchiolitis is a potential alternative diagnosis.
Purpose of the Study:
- To investigate the possibility of misdiagnosis in patients with intractable asthma.
- To identify if chronic bronchiolitis underlies some cases of treatment-resistant asthma.
- To evaluate the efficacy of macrolide therapy in these patients.
Main Methods:
- Seventy-six patients with intractable asthma were initially treated with maximal standard therapies.
- Thirty-five non-responsive patients underwent high-resolution CT (HRCT) scans.
- Patients were divided into two groups: one receiving macrolide therapy without biopsy, the other undergoing biopsy followed by macrolide therapy.
Main Results:
- In the biopsy group, no patient showed asthma pathology; 7 out of 8 had bronchiolitis.
- Both groups treated with macrolides demonstrated significant improvement in dyspnea, cough, and pulmonary function after three months (p<0.001).
- This suggests macrolide therapy is effective for misdiagnosed chronic bronchiolitis.
Conclusions:
- Patients unresponsive to standard intractable asthma treatments may be misdiagnosed with chronic bronchiolitis.
- Expiratory HRCT is recommended for evaluating such patients.
- Macrolide therapy or biopsy can aid in identifying and treating underlying chronic bronchiolitis.
More Related Videos
Related Concept Videos
01:30Asthma-IV: Diagnostic and Management
The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Assessing and diagnosing Chronic Obstructive Pulmonary Disease (COPD) involves a detailed approach that includes a comprehensive review of medical history, physical examination, and a variety of diagnostic tests. This thorough evaluation is essential to ensure an accurate diagnosis and guide effective management strategies.
Medical History
Medical History
01:28Asthma I: Introduction
Asthma is a chronic inflammatory disorder of the airways characterized by variable airflow obstruction and heightened bronchial responsiveness to a wide range of triggers. The underlying inflammation leads to airway swelling, mucus hypersecretion, and smooth muscle constriction, all of which narrow the airway lumen and impede airflow. Clinically, asthma presents with recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing, symptoms that typically vary in intensity and...
01:20Chronic Obstructive Pulmonary Disease-I: Introduction
Chronic Obstructive Pulmonary Disease (COPD) is a long-lasting respiratory condition requiring continuous attention and care. It is a progressive lung disease that leads to breathing challenges due to airflow obstruction. It manifests as persistent respiratory symptoms and restricted airflow resulting from abnormalities in the airways and alveoli, usually due to long-term exposure to harmful particles or gases. COPD mainly consists of two primary conditions: emphysema and chronic bronchitis.
01:24Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features
Chronic bronchitis is a key phenotype of chronic obstructive pulmonary disease (COPD), characterized by airway-centered inflammation and mucus overproduction. It develops from long-term exposure to harmful particles or gases, most commonly cigarette smoke, which triggers a persistent inflammatory response.Cellular and Structural ChangesInflammation initially affects the large bronchi and later the smaller airways, with infiltration by immune cells, including neutrophils, macrophages, and...
01:13Asthma III: Clinical Manifestations
Asthma presents with a characteristic pattern of episodic respiratory symptoms that reflect underlying airway inflammation, bronchoconstriction, and mucus hypersecretion. Although severity varies among individuals, certain clinical manifestations are considered hallmarks of the disorder and often guide diagnosis and assessment.Respiratory SymptomsA persistent cough is one of the most common early features of asthma. It is frequently dry and tends to worsen at night or in the early morning,...