Brittle asthma a report of 2 cases

Abstract

Brittle asthma, even though it is thought to be a rare form of Asthma, may form the bulk of our difficult to treat asthma and frequently unresponsive exacerbation. Brittle Asthma. Brittle asthma is a rare form of severe asthma characterized by a wide variation of Peak Expiratory Flow (PEF)¹, in spite of high doses of inhaled steroids and bronchodilator therapy. Brittle asthmatic patients have very serious and often, life threatening, attacks. There are two forms of brittle asthma.

Case Presentation

We present the cases of a 45yr old Nurse anesthetics who was diagnosed >5yrs ago and a 56yr old unemployed who was diagnosed >15yrs ago. Both have been stable for years on add on maintenance therapy with high doses of inhaled corticosteroid and β₂ agonist as oral salbutamol and an inhaler therapy during exacerbation. Recently, both patients noticed worsening of symptoms despite high dose therapy, They have been in and out of hospital recently for uncontrolled asthma. They later had to be admitted in ICU because of respiratory insufficiency. These two lapsed into brittle asthma with recurrent bronchospasm, due to repeated  to anesthetic agents and environmental exposure at home respectively.

Keywords: Brittle Asthma, Peak Expiratory Flow (PEF), Respiratory Insufficiency, environmental exposure