A 51 year old female, with symptoms of recurrent cough, breathlessness, wheeze diagnosed to have Bronchial Asthma since childhood on regular inhaled bronchodilators and corticosteroids was evaluated.
Diagnosis and Treatment
Spirometry showed severe airway obstruction (FEV1 – 35%) with a significant post bronchodilator reversibility of 19%. Fraction of exhaled Nitric oxide (FeNO) was high (41 ppb). Serum IgE was elevated (865.42 UI/ml ) and serum eosinophils were 5.70%. Severity of bronchial asthma was also assessed using scoring systems such as Asthma control test, Asthma control questionnaire and Asthma quality of life questionnaire(AQLQ).
After thorough clinical examination, the patient was taken up for Bronchial Thermoplasty under General Anaesthesia and three sessions were done with an interval of 3 weeks between each session.
- First session – Right Lower Lobe
- Second session – Left Lower Lobe
- Third session – Both Upper Lobes
At the end of the third session, the patient was re-evaluated. PFT showed significant improvement (FEV1 -58%), reduction in FeNO (28ppb), improvement in quality of life and asthma control.
Patient had no further exacerbations and has been managed with low dose inhaled corticosteroid with oral bronchodilators post procedure.
Patient is under follow up for the past 3 months and is at present on anti allergics and low dose inhaled bronchodilators.
About Author –
Dr. Gopi Krishna Yedlapati, Consultant interventional pulmonologist, Yashoda Hospital, Hyderabad
MD, FCCP, FAPSR (Pulmonology)