Bronchial Asthma: Diagnosis and Long-Term Treatment in Adults
Case No. 1
A 23-year-old woman with known bronchial asthma
presents with acute dyspnea. She is already taking
maintenance therapy with an inhaled corticosteroid
twice daily and, when needed, an inhaled short-acting
beta2 sympathomimetic agent.
The clinical and laboratory findings are as follows:
Shortness of breath while speaking and at rest
Respiratory rate 32/min
Orthopnea
Expiratory wheezes
Prolonged expiratory phase
FEV1 = 2.2 L (61% of normal)
FEV1/IVC = 53%
Arterial blood gases: pO2 = 65 mmHg,
pCO2 = 25 mmHg, pH= 7.49
Asevere asthma attack is diagnosed.
Treatment is provided, consisting of the administration
of prednisolone 50 mg b.i.d. along with continued
inhalational therapy.
Three days later, the FEV1 is 3.52 L, corresponding to
96% of the normal value. The FEV1/IVC ratio is 79%.
Systemic glucocorticoid therapy is stopped after one
week.