a patient with bronchial asthma in whom eosinophilic bronchitis and bronchiolitis developed during treatment：支气管哮喘患者在治疗过程中嗜酸粒细胞性支气管炎和毛细支气管炎.pdf

Allergology International. 2010;59:87-91 DOI: 10.2332allergolint.09-CR-0114 CASE REPORT A Patient with Bronchial Asthma in Whom Eosinophilic Bronchitis and Bronchiolitis Developed during Treatment 1 1 1 1 Yasutsugu Fukushima , Kuniyoshi Kamiya , Masamitsu Tatewaki , Fumiya Fukushima , Hirokuni Hirata1, Yoshiki Ishii1 and Takeshi Fukuda1 ABSTRACT A 56-year-old woman was referred to our hospital because of dyspnea, wheezing, and a productive cough. Eight years before presentation, bronchial asthma was diagnosed and the patient received inhaled corticoster- oids plus antiasthmatic agents (a long-acting inhaled β2-agonist, leukotriene modifiers, and theophylline). Chest radiography showed small diffuse nodular shadows, and a computed tomographic scan showed thicken- ing of the bronchi and bronchioles, with diffuse centrilobular nodules in both lung fields. A blood test and micro- scopic examination of the bronchoalveolar fluid revealed marked eosinophilia. Transbronchial lung biopsy and transbronchial biopsy showed eosinophilic bronchitis and bronchiolitis. After treatment with oral prednisolone (40 mg daily) and inhaled corticosteroids, the symptoms, blood eosinophilia, and radiographic findings im- proved. Recently, several similar cases of eosinophilic bronchiolitis have been reported. Studies of further cases and elucidation of the pathophysiology of eosinophilic bronchiolitis are necessary to establish a concept for this disease and to determine whether it should be classified as a subtype of bronchial asthma or as a dis- tinct entity. KEY WORDS bronchial asthma, bronchiolitis, eosinophilic bronchiolitis, eosinophilic lung disease ABBREVIATIONS TBLB, transbronchial lung biopsy; TBB, transbronchial biops