Near Fatal Asthma: Clinical and Airway Biopsy Characteristics

Richard G. Barbers; Ilias C. Papanikolaou; Michael N. Koss; Ashish Patel; Elton Katagihara; Maggie Arenas; Khalid Chan; Colleen G. Azen; Om P. Sharma

doi:10.1155/2012/829608

Pulmonary Medicine (Jan 2012)

Near Fatal Asthma: Clinical and Airway Biopsy Characteristics

Richard G. Barbers,
Ilias C. Papanikolaou,
Michael N. Koss,
Ashish Patel,
Elton Katagihara,
Maggie Arenas,
Khalid Chan,
Colleen G. Azen,
Om P. Sharma

Affiliations

Richard G. Barbers: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
Ilias C. Papanikolaou: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
Michael N. Koss: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
Ashish Patel: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
Elton Katagihara: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
Maggie Arenas: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
Khalid Chan: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
Colleen G. Azen: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
Om P. Sharma: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA

DOI: https://doi.org/10.1155/2012/829608
Journal volume & issue: Vol. 2012

Abstract

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Background. Inflammation and remodeling are integral parts of asthma pathophysiology. We sought to describe the clinical and pathologic features of near fatal asthma exacerbation (NFE). Methods. Bronchial biopsies were collected prospectively from NFE I subjects. Another NFE II group and a moderate severity exacerbation control group (ME II) were retrospectively identified—no biopsies obtained. Results. All NFE II (𝑛=9) subjects exhibited remodeling and significant inflammation (eosinophilic, neutrophilic). NFE II group (𝑛=37) had a significant history of prior intubation and inhaled corticosteroids usage compared to ME II group (𝑛=41). They also exhibited leukocytosis, eosinophilia, and longer hospitalization days. Conclusions. Remodeling, eosinophilic, and neutrophilic inflammation were observed in NFE. NFE is associated with prior intubation and inhaled corticosteroids usage.

Published in Pulmonary Medicine

ISSN: 2090-1836 (Print); 2090-1844 (Online)
Publisher: Hindawi Limited
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the respiratory system
Website: https://www.hindawi.com/journals/pm/

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