Pulmonary interstitial emphysema in fatal asthma: case report and histopathological review

Thais MauadFelipe B. P. do NascimentoMarisa DolhnikoffMilena C. M. PickaPaulo H. N. Saldiva and on behalf of BIAS

Abstract

Background

Mortality related to asthma has decreased worldwide since the introduction of inhaled corticosteroid therapy in the past decades. However, there are still some asthma fatalities identified mainly in populations with less access to regular treatment. Pulmonary interstitial emphysema due to alveolar rupture has been rarely described as a complication of an acute severe asthma attack, and its identification in pathological analysis can be difficult. Previous studies reported the association of pulmonary interstitial emphysema and bronchial ductal gland ectasia in asthma.

Case presentation

We present the case of a 42-year- old man that died due to a fatal asthma attack. Postmortem computed tomography revealed the unusual finding of acute Pulmonary Interstitial Emphysema, confirmed by pathological analysis. We reviewed 28 cases of fatal asthma tissue and identified the presence of pulmonary interstitial emphysema in 10% of the cases.

Conclusions

Postmortem computed tomography is a useful complimentary diagnostic tool for autopsies. Pulmonary Interstitial Emphysema in acute exacerbations of asthma seems to be more frequent than reported. Alveolar hyperdistension and bronchial duct gland ectasia causing tissue rupture are possible mechanisms involved in the formation of Pulmonary Interstitial Emphysema. The clinical impact of Pulmonary Interstitial Emphysema in asthma is unknown.

Download PDF

(You must be logged in to add and reply comments)

Interasma on Twitter

Interasma RT @Aller_MD: Top story: Is it a food allergy? https://t.co/ESaWtExlry, see more https://t.co/jgCeENQuZt
5hreplyretweetfavorite
Interasma RT @Aller_MD: #Dupilumab (Dupixent) is known to help control atopic dermatitis by diminishing interleukin (IL)-13, but that same mechanism…
5hreplyretweetfavorite
Interasma RT @Aller_MD: “Nasal delivery of leptin hormone may help ease breathing problems during sleep” https://t.co/kPhCp7YbFw https://t.co/mNuyNkD
5hreplyretweetfavorite
Interasma RT @Aller_MD: The 'greying' of T cells: Scientists pinpoint metabolic pathway behind age-related immunity loss https://t.co/V2QIjHJPn1
5hreplyretweetfavorite
Interasma RT @Aller_MD: The latest Allergy, Asthma & Immunology! https://t.co/Thi7i4hPcI Thanks to @GoAllergy @CochraneAirways #eehealthchoices #immu
5hreplyretweetfavorite

Editor: Juan C. Ivancevich, MD

Copyright © Interasma 2003-2017  •  Terms of Use  •  Privacy Policy  •  Contact Us  •  Sitemap

Powered by FREI SA

InterAsma