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Reversible bronchitis and peribronchitis after bronchial thermoplasty

Yamamoto Shota, Iikura Motoyasu, Ishii Satoru, Izumi Shinyu, Hojo Masayuki, Sugiyama Haruhito
European Respiratory Journal 2016 48: PA4191; DOI: 10.1183/13993003.congress-2016.PA4191
Yamamoto Shota
1Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
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Iikura Motoyasu
1Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
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Ishii Satoru
1Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
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Izumi Shinyu
1Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
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Hojo Masayuki
1Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
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Sugiyama Haruhito
1Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
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Abstract

Background: Bronchial thermoplasty (BT) is a non-pharmacological treatment for uncontrolled severe bronchial asthma. This bronchoscopic procedure reduces the mass of airway smooth muscle and attenuates bronchoconstriction by heat energy at 65 °C. Temporary wheezes and respiratory symptoms are reported as an early complication after BT treatment, but its detailed pathomorphological phenomenon is unclear.

Objectives: The aim of this study is to elucidate the short-term adverse events after BT.

Methods: Nine uncontrolled severe asthma patients were undergone BT treatment (27 cases) in our institution since 2015. The mean age was 56.0 years old, the disease duration was 22.7 years, GINA treatment step was 5, exacerbation rate was 4.4 /year. We prospectively studied short-term adverse events after BT treatment.

Results: Average activation counts and time during BT treatment were 56.1 times (75.0 min) at right lower lobe, 51.7 times (69.9 min) at left lower lobe, 85.1 times (78.9 min) at bilateral upper lobes, respectively. Central bronchitis and peri-bronchitis were observed in all cases. Peripheral atelectasis was observed in 3 of 27 cases. Peribronchial opacity appeared several hours after BT. The density and expanse of the opacity peaked at POD 2 and vanished within POD 7. Pneumonia appeared in 3 of 27 cases. Asthma attack required intravenous steroids was observed 2 cases.

Conclusion: Reversible bronchitis and peribronchitis was observed as an inflammatory response to 65°C heat energy after BT treatment.

  • Asthma - management
  • Bronchoscopy
  • Bronchiolitis
  • Copyright ©the authors 2016
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Reversible bronchitis and peribronchitis after bronchial thermoplasty
Yamamoto Shota, Iikura Motoyasu, Ishii Satoru, Izumi Shinyu, Hojo Masayuki, Sugiyama Haruhito
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4191; DOI: 10.1183/13993003.congress-2016.PA4191

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Reversible bronchitis and peribronchitis after bronchial thermoplasty
Yamamoto Shota, Iikura Motoyasu, Ishii Satoru, Izumi Shinyu, Hojo Masayuki, Sugiyama Haruhito
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4191; DOI: 10.1183/13993003.congress-2016.PA4191
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