PMID: 9657586Jul 10, 1998Paper

Serial sputum cell counts in the management of chronic airflow limitation

The European Respiratory Journal
K ParameswaranF E Hargreave

Abstract

This case study illustrates the usefulness of serial induced sputum cell counts from cytospins to investigate the nature of airway inflammation in a patient presumed to have prednisone-dependent asthma for 30 yrs. She had bronchiectasis and chronic airflow limitation. Exacerbations of breathlessness were associated with an increase in chronic airflow limitation with little or no sputum. Induced sputum showed elevated total cell and neutrophil counts at each exacerbation with no increase in the proportion of eosinophils. Pathogenic bacteria were cultured at each flare-up. The dose of prednisone was reduced progressively and each exacerbation was treated with an appropriate antibiotic without increasing the dose of prednisone, as was the case previously. The infections were associated with bronchiectasis of the right upper lobe which was removed. Examination of the specimen confirmed neutrophilic infiltration and did not show the usual airway structural changes of asthma. These results provide further evidence of the value of sputum cell counts in practice, in this case to prevent overtreatment with prednisone in a patient with recurrent deteriorations in airflow which were due to recurrent infections.

Citations

Nov 11, 1999·American Journal of Respiratory and Critical Care Medicine·F E Hargreave, R Leigh
Jun 6, 2006·The Journal of International Medical Research·J ChlumskýJ Vondracek
Nov 21, 2007·Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia·Rogerio RufinoJosé Roberto Lape e Silva
Nov 21, 2014·Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia·Thiago Mamôru SakaeEmílio Pizzichini

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