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Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
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Bronchiectasis after bronchial thermoplasty.

Minzhi Qiu1,2, Zhengdao Lai1,3, Shushan Wei1

  • 1Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.

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|December 4, 2018
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Bronchial thermoplasty (BT) may cause bronchiectasis, a rare complication in severe asthma patients. This case study highlights the need for further safety data on BT treatments.

Keywords:
Bronchiectasisbronchial thermoplastysevere asthma

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Area of Science:

  • Pulmonology
  • Medical Imaging
  • Interventional Pulmonology

Background:

  • Severe refractory asthma treatment often involves bronchial thermoplasty (BT).
  • BT has demonstrated benefits in reducing asthma exacerbations and improving quality of life.
  • Known complications include atelectasis and lung abscess, but bronchiectasis has not been previously reported.

Observation:

  • A 49-year-old male with severe persistent asthma presented with recurrent wheezing.
  • Pre-BT chest CT scans were normal.
  • One month post-BT, high-resolution CT revealed mild central bronchiectasis, persisting for over 4 years.

Findings:

  • This case represents the first reported instance of bronchiectasis following bronchial thermoplasty.
  • Optical coherence tomography (OCT) and a 3-year CT follow-up were utilized.
  • The early onset and persistence of bronchiectasis post-BT remain unexplained.

Implications:

  • This case underscores the necessity for comprehensive short-term and long-term safety evaluations of bronchial thermoplasty.
  • Further research is needed to understand the potential link between BT and bronchiectasis development.
  • Clinicians should consider monitoring for bronchiectasis in patients undergoing BT.