558 Severe Asthma: Report of Five Clinical Cases at West National Medical Center, Imss in Guadalajara City, Mexico

BACKGROUND: Severe asthma can be defined as that which is inadequately or poorly controlled despite an appropriate therapeutic strategy that is adjusted to clinical severity. The aim of this work is to present clinical evidence of 5 patients with high suspect to bear severe asthma. METHODS: We review medical records of 5 patients with high suspect to bear a diagnosis of severe asthma. RESULTS: We present 5 patients, 4 of them were women and just one man. Mean age 49 years old. Two of the patients were detected with nasosinusal polyposis and sensitivity to the aspirin. One of them was diagnosed to bear allergic bronchopulmonary aspergillosis (ABPA). Laboratory blood results reporting: In 4 of the subjects, eosinophils more than 500 cells/mL. IgE with high serum levels in and in the patient with ABPA even with serum levels of 1890 UI/mL. Spirometry values with severe obstructive pattern with FEV1 less than 60% in 3 patients and in 2 of them with obstructive/restrictive severe pattern. In all patients, continuous use of inhaled corticosteroids at high doses alongside another antiasthmatic drug. Usually a long-acting β2-adrenergic, antileukotrien agents, methylxantins and in most of them with daily requirement for short-acting β2-adrenergic rescue medication and with more than 3 or more courses of oral corticosteroids in the last year. CONCLUSIONS: Because of the clinical findings of our patients, respiratory function test and characteristics of the treatment which they have had during the last 5 years we consider that our patients bear severe asthma according with American Thoracic Society and is our purpouse to share with other immunoallergist our clinical experience in this field.