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Case Reports in Medicine
Volume 2013, Article ID 735058, 4 pages
http://dx.doi.org/10.1155/2013/735058
Case Report

Refractory Asthma Treatment Is Complicated by Tracheobronchomalacia: Case Reports and Review of the Literature

Division of Allergy and Clinical Immunology, Department of Medicine, Phramongkutklao Hospital, Bangkok 10400, Thailand

Received 12 January 2013; Accepted 22 April 2013

Academic Editor: Mamede de Carvalho

Copyright © 2013 Sawad Boonpiyathad and Atik Sangasapaviliya. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Tracheobronchomalacia (TBM) is defined as the condition where the airway lumen narrows more than 50 percent. The acquired TBM usually occurs in adults; however, the prevalence of TBM in asthma is unknown. We report two cases of severe asthma in elderly patients that could not be controlled with higher medication use. Case 1 was a 70-year-old woman with sever persistent asthma for 10 years, presented with uncontrolled symptoms for 4 months. A CT of the chest showed collapse of the trachea at the posterior wall. Case 2 involved a 72-year-old woman with partly controlled asthma presenting with uncontrolled symptoms for 3 months. A CT of the chest showed normal distal tracheal anteroposterior diameter. However, bronchoscopy showed bronchomalacia at the right and left bronchus of the lower lungs. Patients who have severe asthma, despite adequate treatment with medication, should be further investigated to exclude other diseases that have clinical features similar to asthma such as tracheobronchomalacia, particularly in the elderly.