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Pulmonary Literature Review and Complex Case Prese ...
ComplexCasesSevereAsthma Rogers
ComplexCasesSevereAsthma Rogers
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Pdf Summary
The Pulmonary Literature Review for Complex Cases in 2024, presented by Linda Rogers, MD, highlights various challenging scenarios in asthma management, focusing on non-FDA approved treatments and the utility of biomarkers in selecting appropriate therapies. The document explores several case studies emphasizing severe asthma treatment and complications arising from biological therapies.<br /><br />One case features a 32-year-old patient experiencing asthma exacerbations despite using high-dose inhalers. The patient's allergy testing showed sensitization to multiple allergens, elevated FeNO levels, and moderate blood eosinophil counts, suggesting type-2 severe asthma. The discussion encourages selecting among biologics such as anti-IL5/IL5ra, anti-IgE, anti-IL4ra, and anti-TSLP based on the patient's specific biomarker profile. Another case involves Dupilumab treatment resulting in adverse eosinophilic effects, such as elevated blood eosinophil counts and potential eosinophilic pneumonia, highlighting the need for careful monitoring.<br /><br />The review also discusses a patient suspected of having eosinophilic granulomatosis with polyangiitis (EGPA) due to high eosinophil levels and symptoms like nasal congestion and asthma flares, using EGPA criteria and factors from the Five Factor Score (FFS) to assess mortality risk. The document provides insights into eosinophilic disorders and steroid-sparing strategies with biologics such as Mepolizumab, Dupilumab, and Benralizumab, crucial for patients reliant on oral corticosteroids.<br /><br />Furthermore, the review addresses a complex case of inborn errors of immunity and asthma. It describes a patient with a history of frequent infections and immune deficiency, managing complications with treatments like IVIG, azithromycin, and CPAP.<br /><br />Overall, the session underscores the importance of personalized treatment strategies for asthma using biologics and recognizing rare complications or underlying conditions that may influence disease management.
Keywords
asthma management
biomarkers
severe asthma
biologics
eosinophilic disorders
Dupilumab
EGPA
steroid-sparing
immune deficiency
personalized treatment
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