Bronchial asthma is often accompanied with allergic rhinitis or chronic sinusitis. Mucosal abnormalities of sinonasal cavity may influence lower respiratory responses in patients with asthma. We experienced a case of 72-year-old woman with asthma, who had dyspnea on exertion and a large volume of expectoration of more than 100mℓ a day. Furthermore she had nasal symptoms (nasal obstruction and rhinorrea) with prominent post-nasal discharge. Computed tomography (CT) scans of sinonasal cavity revealed marked thickness of nasal mucosa. Although her asthma symptoms such as wheezing and dyspnea improved by administration of
bronchodialators, antiallergic agent, and beclomethason di isocyanate (BDI) accompanied with spa therapy after admission, the volume of expectoration revealed no decrease and her peak expiratory flow (PEF) didn't increase. The volume of expectoration and the PEF showed marked improvement after starting of intranasal glucocorticoid therapy. It is suggested from her clinical course that treatment with intranasal glucocorticoids is very important in asthmatic patients with mucosal abnormalities of sinonasal cavity.
bronchial asthma (気管支喘息)
intranasal steroid therapy (鼻腔内吸入ステロイド療法)
peak expiratory flow (ピークフロー)