Proč bronchoskopovat pacienty s obtížně léčitelným astmatem?
| Title in English | Why perform bronchoscopy in patients with difficult-to-manage asthma? |
|---|---|
| Authors | |
| Year of publication | 2012 |
| Type | Article in Periodical |
| Magazine / Source | Studia Pneumologica et Phthiseologica |
| MU Faculty or unit | |
| Citation | |
| Field | Pneumology |
| Keywords | bronchial asthma; difficult-to-treat asthma; bronchoscopy |
| Description | Bronchial asthma is currently one of the most frequent chronic diseases. Although the disease is incurable, response to treatment is very good in most cases. With adequate therapy, a vast majority of patients have asthma under control, being stabilized and without symptoms. However, there is a group of patients with difficult-to-treat asthma and everyday symptoms despite high-quality care and good compliance. In only 5 % of cases, asthma is difficult to treat in the true sense of the word. If severe or difficult-to-treat asthma is suspected, it is therefore necessary to confirm the patient's diagnosis and adherence to therapy, to verify whether treatment is adequate and whether comorbidities potentially aggravating the course of asthma are diagnosed and treated. If bronchial hyper-reactivity (bronchodilation and bronchoconstriction) test results are negative, histological confirmation of the diagnosis is advisable. Thus, in diagnostically ambiguous cases, bronchoscopy with endobronchial or even trans-bronchial biopsy are indicated. This examination should be performed by an experienced bronchoscopic team cooperating with a pathologist. The authors studied 106 patients suspected of difficult-to-treat asthma in whom diagnostic bronchoscopy was performed in 2009-2012. In the group, endobronchial biopsy was diagnostically beneficial in 86 patients. The diagnosis of bronchial asthma was histologically confirmed in 51.16 % of them; the remaining 48.8 % did not have bronchial asthma but other conditions (chronic obstructive pulmonary disease, gastroesophageal reflux, chronic bronchitis, interstitial lung disease, lung cancer, tracheal dyskinesia, foreign bodies or combinations of the above). |