1. ASTHMA
ANAND.M
09’ALTHEANZ

2. A patient named Ramani , 45yrs old came with
complaints of breathlessness, cough and
chest tightness. On history, we came to know
that the patient visited a stone quarry a day
before. On serum examination the blood IgE
level & eosinophil count is high. What would
be the diagnosis and management ?

3. ASTHMA
 Asthma is characterized by chronic
airway inflammation and increased
airway hyper responsiveness leading
to symptoms of wheeze ,cough, chest
tightness and dyspnoea.
 It is characterised functionally by the
presence of air flow obstruction-
variable over short period reversible
with treatment

4. ETIOLOGY
 Complex and multiple environmental
and genetic determinants.
 Hygiene hypothesis -decreased
infection in early life
 Infections – respiratory synctial
viruses
 Allergens – pet exposure , food
particle
 Air pollution

5. ETIOLOGY

6. PATHO PHYSIOLOGY
• Reverses spontaneously on treatment
Airway
limitation
• Exaggerated broncho-constriction
Airway
hyper-
reactivity
• Edema
• Smooth muscle hypertrophy, hyperplasia
• Mucous plugging
Airway
inflammation

8. Inhaled allergens
interact with mast cells
Histamine and
cysteinyl leukotrienes
Bronchoconstriction
In case of inhaled allergens

9. Influx of inflammatory cells
Transformation and
participation of airway
structural cells
Secretion of cytokines ,
chemokines and growth
factors
In persistent asthma

11. CLINICAL FEATURES
 Recurrent episodes of wheeze ,cough,
chest tightness and dyspnoea.
 Nocturnal asthma
 Cough-variant asthma
 Aspirin sensitive asthma
 Occupational asthma

12. INVESTIGATIONS
Pulmonary function tests
Radiological examination
Skin prick test
Measurement of FEV and VC by Spirometry
Hyper inflammation, lobar collapse and mucous occlusion
Serum IgE examination

13. 5. Addition of regular oral corticosteroid
therapy
4. High dose inhaled corticosteroids and regular
bronchodilators
3. Low to moderate doe inhaled corticosteroids
plus long acting inhaled β2-adrenoceptor
agonists or leucotriene receptor antagonist
2. Low dose inhaled corticosteroids or other
anti-inflammatory agents
1. Occasional use of inhaled short acting β2-
adrenoceptor agonists
Step wise management of asthma

14. Thank you