Brittle asthma

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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W8MD medical weight loss NYC and sleep center NYC

Brittle asthma
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Severe asthma attacks, wheezing, shortness of breath, coughing
Complications	Respiratory failure, pneumothorax, status asthmaticus
Onset	Typically in childhood or adolescence
Duration	Chronic
Types	Type 1 (wide peak flow variability), Type 2 (sudden severe attacks)
Causes	Allergens, respiratory infections, exercise, stress
Risks	Poorly controlled asthma, allergy, smoking, family history
Diagnosis	Spirometry, peak flow monitoring, allergy testing
Differential diagnosis	Chronic obstructive pulmonary disease, vocal cord dysfunction, heart failure
Prevention	Avoidance of triggers, regular use of inhaled corticosteroids
Treatment	Bronchodilators, corticosteroids, biologics, oxygen therapy
Medication	Salbutamol, prednisone, omalizumab
Prognosis	Variable; can be life-threatening if not managed
Frequency	Rare
Deaths	N/A

A severe form of asthma characterized by sudden and severe attacks

Diagram of the lungs affected by asthma

Brittle asthma is a rare and severe form of asthma that is characterized by sudden and severe attacks that can be life-threatening. It is distinguished from other forms of asthma by its unpredictability and the difficulty in controlling symptoms with standard treatments.

Types

Brittle asthma is classified into two types:

Type 1 Brittle Asthma

Type 1 brittle asthma is characterized by a wide variation in peak expiratory flow (PEF) despite intense medical therapy. Patients with this type experience frequent and severe asthma attacks that can occur suddenly and without warning.

Type 2 Brittle Asthma

Type 2 brittle asthma involves sudden, severe attacks on a background of otherwise well-controlled asthma. These attacks can be life-threatening and require immediate medical attention.

Symptoms

The symptoms of brittle asthma are similar to those of other forms of asthma but are more severe and unpredictable. They include:

• Severe dyspnea (shortness of breath)
• Wheezing
• Coughing
• Chest tightness
• Rapid deterioration of lung function

Causes

The exact cause of brittle asthma is not well understood, but it is believed to involve a combination of genetic, environmental, and immunological factors. Triggers can include:

• Allergens
• Infections
• Stress
• Exercise

Diagnosis

Diagnosis of brittle asthma involves a thorough medical history, physical examination, and lung function tests. It is important to distinguish brittle asthma from other forms of severe asthma to tailor appropriate treatment strategies.

Treatment

Treatment of brittle asthma is challenging and often requires a multidisciplinary approach. It may include:

• High-dose inhaled corticosteroids
• Oral corticosteroids
• Bronchodilators
• Biologic therapies
• Oxygen therapy
• Hospitalization during severe attacks

Prognosis

The prognosis for individuals with brittle asthma varies. With appropriate management, some patients can achieve better control of their symptoms, but the condition can be life-threatening if not properly managed.

Prevention

Preventive measures for brittle asthma focus on avoiding known triggers and adhering to prescribed treatment plans. Regular follow-up with healthcare providers is essential to monitor and adjust treatment as needed.

See also

• Asthma
• Chronic obstructive pulmonary disease
• Respiratory therapy