Successful treatment of coronavirus disease 2019 in a patient with asthma

2020 ◽  
Vol 41 (4) ◽  
pp. 296-300
Author(s):  
Avni Y. Joshi ◽  
Roshini M. Mullakary ◽  
Vivek N. Iyer
Keyword(s):  
Inhaled Corticosteroids ◽  
Prolonged Mechanical Ventilation ◽  
Health Care Facilities ◽  
Asthma Therapy ◽  
Antibody Testing ◽  
Rna Detection ◽  
Current Time ◽  
Cough Variant Asthma ◽  
Controller Medications ◽  
Function Testing

Underlying lung disease, especially asthma, has recently been found to be associated with a higher risk of hospitalization with coronavirus disease 2019 (COVID-19) infection. Inhaled corticosteroids (ICS) are the most commonly used controller medications in patients with asthma. It is unclear whether ICS use increases the risk for severe COVID-19 infection. At the current time, asthma organizations are still recommending the continued use of ICS and other asthma medications to minimize the risk of uncontrolled asthma. However, for patients with asthma and who have recovered from COVID-19 infection, the timing of resumption of asthma therapy is equally uncertain. Pulmonary function testing and exhaled oral nitric oxide testing are aerosol-generating procedures and are currently being severely restricted at most health-care facilities. We presented a case of a patient with cough-variant asthma who developed severe COVID-19 associated acute respiratory distress syndrome with the need for intubation and prolonged mechanical ventilation. We highlighted the potential utility of using COVID-19 RNA detection as well as immunoglobulin G antibody testing to help guide the timing of resumption of asthma therapy.

scholarly journals The impact of inhaled corticosteroids on cough and bronchial hyperreactivity in cough variant asthma

2010 ◽  
Vol 63 (3-4) ◽  
pp. 170-174 ◽  
Author(s):  
Ivana Stankovic ◽  
Tatjana Pejcic ◽  
Milan Rancic ◽  
Branislava Milenkovic
Keyword(s):  
Chronic Cough ◽  
Airway Hyperresponsiveness ◽  
Therapeutic Approach ◽  
Inhaled Corticosteroids ◽  
Bronchial Hyperresponsiveness ◽  
Asthma Therapy ◽  
Cough Variant Asthma ◽  
Group A ◽  
Group B ◽  
The Impact

Introduction Classic asthma is characterized by cough, wheezing and dyspnea. Cough, however, may be the sole presenting symptom of asthma and this type of asthma is known as cough-variant asthma. The therapeutic approach to cough variant asthma is similar to that of the typical form of asthma. A diagnosis of cough-variant asthma is made when a chronic cough is associated with airway hyperresponsiveness and a favorable response to asthma therapy in the absence of other discernible cause. The aims of this study were to analyze the influence of inhaled corticosteroids on cough and bronchial hyperresponsiveness. Material and methods The study included 55 patients with cough as the sole presenting symptom. 40 patients (Group A) were treated with inhaled corticosteroids and beta2 agonists for eight weeks while 15 patients (Group B) were treated only with oral beta2 agonists. The non-specific bronchoprovocative test with histamine was performed on all the patients before the treatment and after the examination and there was established the provocative dose of histamine causing the 20% fall in FEV1 (PD20). Results At the end of the study in Group A we found a statistically significant decrease of PD20 0.98?0.86 vs 1.58?1.06 (p<0.005), while in Group B there were no significant changes. In 90% of the patients treated with inhaled corticosteroids the cough was completely relieved while in 80% of the patients treated with only beta2 agonists the cough has remained unchanged. Conclusion Inhaled corticosteroids are choice drugs for the treatment of cough-variant asthma because they relieve cough and decrease bronchial hyperresponsiveness, thus ultimately reducing the risk of classic asthma.

Pembrolizumab Induced Acute Persistent Airway Disease in a Patient with Recurrent Respiratory Papillomatosis (RRP)

2021 ◽  
pp. 000348942110212
Author(s):  
Kathryn Marcus ◽  
Daniel J. Lee ◽  
Jeffrey S. Wilson ◽  
Richard J. H. Smith ◽  
Michael Puricelli
Keyword(s):  
Respiratory Failure ◽  
Inhaled Corticosteroids ◽  
Checkpoint Inhibitor ◽  
Ventilatory Support ◽  
Airway Disease ◽  
Recurrent Respiratory Papillomatosis ◽  
Pulmonary Function Testing ◽  
Hypoxic Respiratory Failure ◽  
Checkpoint Inhibitor Therapy ◽  
Function Testing

Objective: To present an uncommon but serious, recently identified complication of checkpoint inhibitor therapy in a patient treated with pembrolizumab infusion for disseminated recurrent respiratory papillomatosis (RRP). Methods: Case report. Results: A 43-year-old woman with underlying asthma developed acute hypoxic respiratory failure within 24 hours of her third infusion of pembrolizumab for treatment of intractable, disseminated recurrent respiratory papillomatosis. Pulmonary function testing revealed a severe intra-thoracic obstructive ventilatory defect. Discontinuation of pembrolizumab, ventilatory support, and treatment with systemic and inhaled corticosteroids resulted in resolution of respiratory failure; however, her underlying asthma remains poorly controlled. Conclusion: To our knowledge, this case is the first report of pembrolizumab-induced obstructive respiratory failure in a patient being treated for RRP.

Hypoglycemia and Cortisol Deficiency Associated With Low-dose Corticosteroid Therapy for Asthma

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 921-924
Author(s):  
Aaron L. Carrel ◽  
Stephanie Somers ◽  
Robert F. Lemanske ◽  
David B. Allen
Keyword(s):  
Adverse Effects ◽  
Low Dose ◽  
Inhaled Corticosteroids ◽  
Chronic Asthma ◽  
Asthma Therapy ◽  
Biochemical Alterations ◽  
Clinically Significant ◽  
Dose Corticosteroid ◽  
Oral Glucocorticoids ◽  
Cortisol Deficiency

Glucocorticoids are a cornerstone of the anti-inflammatory treatment of asthma. To minimize adverse effects of oral glucocorticoids (OGC), clinicians have used alternate-day oral or inhaled corticosteroids (IC), both generally considered safe for chronic asthma therapy in children. Although reversible growth suppression occasionally occurs, the general consensus is that, despite detectable biochemical alterations, these modes of therapy are not associated with clinically significant adrenal insufficiency.1 We report the occurrence of hypoglycemia due to cortisol deficiency during combination alternate-day oral and inhaled corticosteroids. CASE HISTORY A 3½-year-old boy with asthma was found one morning to be unarousable, limp, and blue around the lips.

scholarly journals Chikungunya Virus RNA and Antibody Testing at a National Reference Laboratory since the Emergence of Chikungunya Virus in the Americas

2014 ◽  
Vol 22 (3) ◽  
pp. 291-297 ◽  
Author(s):  
Harry E. Prince ◽  
Brent L. Seaton ◽  
Jose L. Matud ◽  
Hollis J. Batterman
Keyword(s):  
Chikungunya Virus ◽  
Large Data ◽  
Nucleic Acid Amplification ◽  
Antibody Detection ◽  
Reference Laboratory ◽  
Antibody Testing ◽  
Data Set ◽  
Rna Detection ◽  
Antibody Titers ◽  
The Relationship

ABSTRACTSince first reported in the Americas in December 2013, chikungunya virus (CHIKV) infections have been documented in travelers returning from the Caribbean, with many cases identified by CHIKV antibody and/or RNA testing at our laboratory. We used our large data set to characterize the relationship between antibody titers and RNA detection and to estimate IgM persistence. CHIKV RNA was measured by nucleic acid amplification and CHIKV IgG/IgM by indirect immunofluorescence. Of the 1,306 samples submitted for RNA testing in January through September 2014, 393 (30%) were positive; for 166 RNA-positive samples, CHIKV antibody testing was also ordered, and 84% were antibody negative. Of the 6,971 sera submitted for antibody testing in January through September 2014, 1,811 (26%) were IgM positive; 1,461 IgM positives (81%) were also IgG positive. The relationship between the CHIKV antibody titers and RNA detection was evaluated using 376 IgM-positive samples (138 with RNA testing ordered and 238 deidentified and tested for RNA). RNA detection showed no significant association with the IgM titer but was inversely related to the IgG titer; 63% of the IgG negative sera were RNA positive, compared to 36% of sera with low IgG titers (1:10 to 1:80) and 16% with IgG titers of ≥1:160. Using second-sample results from 62 seroconverters, we estimated that CHIKV IgM persists for 110 days (95% confidence interval, 78 to 150 days) after the initial antibody-negative sample. These findings indicate that (i) RNA detection is more sensitive than antibody detection early in CHIKV infection, (ii) in the absence of RNA results, the IgG titer of the IgM-positive samples may be a useful surrogate for viremia, and (iii) CHIKV IgM persists for approximately 4 months after symptom onset.

scholarly journals Asthma Controller Medications for Children in Japan

2015 ◽  
Vol 2 ◽  
pp. 2333794X1557779 ◽  
Author(s):  
Shota Hamada ◽  
Hironobu Tokumasu ◽  
Akira Sato ◽  
Masahiro Iwasaku ◽  
Koji Kawakami
Keyword(s):  
Inhaled Corticosteroids ◽  
Management Strategies ◽  
Preschool Age ◽  
Prescribing Patterns ◽  
School Age Children ◽  
Administrative Claims ◽  
School Age ◽  
Number Of Children ◽  
Controller Medications ◽  
Antiasthma Drugs

Background. Treatment and management strategies for asthma in children are generally consistent internationally, but prescription of antiasthma drugs differs among countries. The objective of this study was to examine the prescribing patterns of antiasthma drugs, particularly controller medications, in children. Methods. A retrospective cohort study was performed in children with asthma using an administrative claims database in Japan. Results. A total of 1149 preschool-age and 3226 school-age children were identified. Leukotriene receptor antagonists were prescribed for about 80% of the children. Long-acting β-agonists were prescribed for 87.6% and 59.6% of preschool-age and school-age children, respectively, whereas prescriptions of inhaled corticosteroids had lower rates of 8.2% and 16.5%, respectively. In an examination of prescriptions at 1-month intervals, a relatively high number of children were prescribed bronchodilators without anti-inflammatory agents. Conclusion. Our findings suggest that asthma care for children in Japan can be improved through changes in drug prescriptions.

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