Abstract
Objective: We examined sputum cytology repeatedly for one intractable asthmatic patient and compared the results with clinical conditions to determine whether sputum cytology work as a tool for monitoring airway inflammation.
Methods: The case was 4-year-old girl with severe persistent asthma. She has been hospitalized 10 times for asthma exacerbation and twice for pneumonia in the last one year. We obtained spontaneous sputum in exacerbation phases, and induced sputum in stable phases for differential cell counts.
Results: Four or five days after sputum eosinophils increased to 50 to 60%, she was admitted to hospital for acute exacerbation. Systemic steroid therapy for acute exacerbation decreased sputum eosinophils to 5-10%. In acute phase of pneumonia, sputum neutrophils occupied 90% and eosinophils almost disappeared. Sputum eosinophils were usually more than 10%, but when she stayed at mother's home island for one month in summer vacation, asthma symptom disappeared, and eosinophils decreased to 4% without using systemic steroids.
Conclusions: Sputum cytology can be a useful tool for monitoring bronchial inflammation.
