A diagnostic approach and natural course of a patient with asthma–COPD overlap syndrome

Respirology Case Reports

Hyun Lee³  Nguyen Van Tho⁴  Yasutaka Nakano¹  Byung-Jae Lee² 

[1] Division of Respiratory Medicine, Department of Internal Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan;Division of Allergy, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea;Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea;Respiratory Care Center, University Medical Center, Ho Chi Minh City, Vietnam

关键词: Asthma;    chronic obstructive pulmonary disease;    diagnosis;   

DOI  :  10.1002/rcr2.130

来源: Wiley

【 摘 要 】

Abstract

The diagnostic criteria of asthma–chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) advocated by the Global Initiative for Asthma (GINA)/Global Initiative for Chronic Obstructive Lung Disease (GOLD) are somewhat complicated, and limited data are available regarding how ACOS patients respond to current medications. We present a case of a 64-year-old man with ACOS. With features favoring asthma including childhood asthma history with intermittent episodes of dyspnea at night, elevated blood eosinophil count and total IgE, increased forced expiratory volume in 1 s (FEV₁) after bronchodilator (>200 mL and >12% from baseline), and positive skin prick tests, he also had features favoring COPD such as heavy smoker, persistent exertional dyspnea, and airflow limitation after inhaled therapy. Over 5-year follow up, our patient experienced a single episode of moderate exacerbation. However, post-bronchodilator FEV₁ decreased by 240 mL for 4 years (−60 mL/year) after 1.5 years of treatment, indicating rapid lung function decline. Longitudinal studies are necessary to assess optimal interventions and natural course of ACOS.

【 授权许可】

CC BY-NC   
© 2015 The Authors. Respirology Case Reports published by John Wiley & Sons Ltd on behalf of The Asian Pacific Society of Respirology.

Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.