Asthma of recent onset in a 43 years-old lady (2007)
Authors: Sonia Vázquez-Cortés, MD (1)
Isabel Reig, MD (1)
Cristina Benito, BSc (2)
Consuelo Martínez-Cócera, MD PhD (1)
Montserrat Fernández-Rivas, MD PhD (1)
(1) Servicio de Alergia, Hospital Clínico San Carlos, Madrid, Spain
(2) Laboratorio de Investigación, Fundación Hospital Alcorcón, Alcorcón, Spain
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A 43 years-old woman was referred to our Allergy Department by her general physician for a 6 months history of asthma and blood eosinophilia.
She reported cough, wheeze and shortness of breath daily that were initially treated with inhaled salbutamol. Rhinoconjunctival symptoms were absent and fever has not been associated. She had presented two severe exacerbations that required emergency care assistance with oxygen, nebulised salbutamol and budesonide, and systemic corticosteroids. Afterwards treatment with inhaled budesonide 160 µg and formoterol 4.5 µg twice a day was started by her general practitioner. Adherence to treatment was poor and the patient needed to use the salbutamol inhaler everyday.
Non-steroidal anti-inflammatory drugs (NSAIDs) were well tolerated, and she denied the intake of any medication. She smoked around 10 cigarettes a day. She had never suffered any relevant illness, she had never travelled abroad, and she had no personal or family history of atopy or asthma.
She worked as a housekeeper and reported worsening of her asthma symptoms when she returned home in the evening. She had noticed an important improvement during a 3 days holiday away from home. Exposure to potential indoor allergens was carefully collected and the only relevant data were the presence of an iguana pet at home for 4 years and a dog for the last year. Cockroaches had been observed at home in the last 6 months. The physical exam was normal including cardiopulmonary auscultation.