29:
153:
estimates a prevalence of approximately 0.05% brittle asthma sufferers among the asthmatic population. Though found in all ages, it is most commonly found in individuals between the ages of 18 and 55; it is present in both sexes, though type 1 has been diagnosed in three times as many women as men.
57:
distinguishable from other forms by recurrent, severe attacks. There are two subtypes divided by symptoms: Type 1 and Type 2, depending on the stability of the patient's maximum speed of expiration, or peak expiratory flow rate (PEFR). Type 1 is characterized by a maintained wide PEF variability
93:
distinguishes type 1 brittle asthma by "persistent daily chaotic variability in peak flow (usually greater than 40 per cent diurnal variation in PEFR more than 50 per cent of the time)", while type 2 is identified by "sporadic sudden falls in PEFR against a background of usually well-controlled
102:, and chest tightness. Individuals with type 1 suffer chronic attacks in spite of ongoing medical therapy, while those with type 2 experience sudden, acute and even potentially life-threatening attacks even though otherwise their asthma seems well managed.
65:
Brittle asthma is one of the "unstable" subtypes of "difficult asthma", a term used to characterize the less than 5% of asthma cases that do not respond to maximal inhaled treatment, including high doses of
958:
133:, whilst type 2 needs allergen avoidance and self-management approaches. Since catastrophic attacks are unpredictable in type 2, patients may display identification of the issue, such as a
94:
asthma with normal or near normal lung function". In both types, patients are subject to recurrent, severe attacks. The cardinal symptoms of an asthma attack are shortness of breath (
58:
despite considerable medical therapy including a dose of inhaled steroids, and Type 2 is characterized by sudden acute attacks occurring in less than three hours without an obvious
419:
Saunders (2005). "Asthma". In Homer A. Boushey Jr., M.D.; David B. Corry, M.D.; John V. Fahy, M.D.; Esteban G. Burchard, M.D.; Prescott G. Woodruff, M.D.; et al. (eds.).
577:
109:
in 1977, the term brittle asthma was used specifically to describe type 1, but as studies into the phenotype were conducted the second type was also distinguished.
1422:
1177:
1201:
973:
948:
452:
130:
1634:
1417:
1172:
570:
1427:
1223:
1624:
1404:
904:
599:
594:
364:
179:
1368:
1639:
563:
1105:
129:, brittle asthma treatment also involves for type 1 additional subcutaneous injections of beta2 agonist and inhalation of
1213:
1665:
1412:
1363:
1196:
1134:
1373:
89:
1559:
1432:
1057:
1031:
756:
657:
1208:
1036:
1021:
1014:
919:
880:
827:
805:
763:
691:
138:
71:
1187:
1336:
978:
894:
769:
106:
1462:
1315:
1276:
1191:
1144:
843:
686:
724:
696:
118:
1341:
1293:
1281:
1095:
1053:
652:
1609:
1576:
1322:
1271:
899:
719:
586:
359:. Oxford Medical Publications. Vol. 3 (4th ed.). Oxford University Press. p. 1346.
1467:
1332:
1288:
1120:
1041:
968:
838:
1589:
833:
662:
623:
528:
477:
448:
389:
360:
337:
288:
239:
204:
175:
1532:
1525:
1389:
1310:
1149:
1085:
934:
518:
508:
327:
319:
278:
270:
231:
1660:
1554:
1506:
1394:
1345:
1266:
1182:
990:
380:
Ogorodova LM, Selivanova PA, Gereng EA, Bogomiakov VS, Volkova LI, Pleshko RI (2008). "".
1492:
1154:
1065:
985:
795:
790:
332:
283:
258:
122:
67:
59:
195:
Gupta D, Ayres JG (2001). "Brittle asthma: a separate clinical phenotype of asthma?".
1654:
1584:
1298:
1009:
555:
1521:
1474:
859:
811:
680:
126:
1619:
1566:
1549:
1544:
1497:
1452:
1303:
1251:
1218:
1090:
819:
751:
714:
669:
604:
235:
1539:
1139:
1125:
1100:
1075:
1070:
1004:
953:
875:
851:
800:
674:
639:
614:
134:
513:
496:
1614:
1246:
1115:
1110:
1080:
631:
28:
532:
495:
Toungoussova O, Foschino
Barbaro MP, Esposito LM, et al. (June 2007).
481:
393:
243:
208:
341:
307:
292:
1629:
1514:
914:
647:
323:
274:
170:
Holgate, Stephen T.; Homer A. Boushey; Leonardo M. Fabbri, eds. (1999).
867:
743:
95:
523:
964:
777:
706:
99:
54:
785:
734:
559:
468:
Graziani E, Petroianni A, Terzano C (2004). "Brittle asthma".
222:
Ayres JG, Jyothish D, Ninan T (March 2004). "Brittle asthma".
421:
Mason: Murray & Nadel's
Textbook of Respiratory Medicine
154:
Hospitalization is more frequent for type 1 than type 2.
70:
combined with additional therapies such as long-acting
1602:
1575:
1505:
1491:
1445:
1403:
1382:
1356:
1259:
1245:
1236:
1165:
1050:
1030:
913:
893:
733:
613:
593:
40:
21:
306:Ayres, J. G.; Miles, J. F.; Barnes, P. J. (1998).
44:Allergen avoidance and self-management approach
571:
8:
257:Ayres JG, Miles JF, Barnes PJ (April 1998).
357:Oxford textbook of medicine: Sections 18-33
62:on a background of well controlled asthma.
1502:
1256:
1242:
1047:
910:
610:
578:
564:
556:
27:
18:
1178:Combined pulmonary fibrosis and emphysema
522:
512:
331:
282:
1202:Allergic bronchopulmonary aspergillosis
546:
544:
542:
405:
403:
162:
131:long acting beta-adrenoceptor agonist
7:
174:. Informa Health Care. p. 291.
1635:Idiopathic pulmonary haemosiderosis
447:. Wiley-Interscience. p. 122.
1224:Vaping-associated pulmonary injury
587:Diseases of the respiratory system
14:
1640:Pulmonary alveolar proteinosis
149:The condition is rare. 1999's
1:
1214:Idiopathic pulmonary fibrosis
197:Indian J Chest Dis Allied Sci
117:In addition to any issues of
1197:Respiratory hypersensitivity
1135:Hypersensitivity pneumonitis
445:Asthma Care in the Community
1106:Coalworker's pneumoconiosis
90:Oxford Textbook of Medicine
1682:
959:Acute exacerbation of COPD
355:Warrell, David A. (2005).
236:10.1016/j.prrv.2003.09.003
470:Eur Rev Med Pharmacol Sci
423:(4th ed.). Elsevier.
35:
26:
1022:Diffuse panbronchiolitis
1015:Bronchiolitis obliterans
881:Laryngotracheal stenosis
828:Laryngopharyngeal reflux
806:Laryngopharyngeal reflux
764:Laryngopharyngeal reflux
692:Nasal septum perforation
514:10.4081/monaldi.2007.497
139:epinephrine autoinjector
770:Retropharyngeal abscess
137:bracelet, and carry an
107:Margaret Turner-Warwick
1463:Pulmonary hypertension
1192:Eosinophilic pneumonia
844:Vocal cord dysfunction
687:Nasal septum deviation
501:Monaldi Arch Chest Dis
443:Waldron, Jill (2007).
125:(inhaled or oral) and
105:When first defined by
1590:Mediastinal emphysema
1369:Healthcare-associated
1299:Legionnaires' disease
725:Peritonsillar abscess
697:Nasal septal hematoma
1337:Mendelson's syndrome
1209:Hamman–Rich syndrome
550:Holgate et al., 293.
433:Holgate et al., 292.
324:10.1136/thx.53.4.315
275:10.1136/thx.53.4.315
119:treatment compliance
1666:Respiratory therapy
1610:Respiratory failure
1577:Mediastinal disease
1145:Bird fancier's lung
720:Adenoid hypertrophy
224:Paediatr Respir Rev
1515:Pleuritis/pleurisy
1468:Pulmonary embolism
1364:Community-acquired
1289:Atypical bacterial
1188:Löffler's syndrome
969:Status asthmaticus
954:Chronic bronchitis
839:Vocal fold paresis
653:Vasomotor rhinitis
1648:
1647:
1598:
1597:
1555:Empyema/pyothorax
1487:
1486:
1483:
1482:
1441:
1440:
1374:Hospital-acquired
1232:
1231:
1096:Caplan's syndrome
889:
888:
834:Vocal fold nodule
658:Atrophic rhinitis
454:978-0-470-03000-4
48:
47:
16:Medical condition
1673:
1533:Pleural effusion
1526:Hemopneumothorax
1503:
1257:
1243:
1086:Bauxite fibrosis
1051:External agents/
1048:
979:Exercise-induced
935:Acute bronchitis
911:
611:
580:
573:
566:
557:
551:
548:
537:
536:
526:
516:
497:"Brittle asthma"
492:
486:
485:
465:
459:
458:
440:
434:
431:
425:
424:
416:
410:
407:
398:
397:
377:
371:
370:
352:
346:
345:
335:
308:"Brittle asthma"
303:
297:
296:
286:
259:"Brittle asthma"
254:
248:
247:
219:
213:
212:
192:
186:
185:
172:Difficult asthma
167:
151:Difficult Asthma
121:, and maximised
31:
19:
1681:
1680:
1676:
1675:
1674:
1672:
1671:
1670:
1651:
1650:
1649:
1644:
1594:
1571:
1507:Pleural disease
1496:
1479:
1437:
1399:
1383:By distribution
1378:
1357:By vector/route
1352:
1250:
1238:
1228:
1183:Pulmonary edema
1161:
1056:
1052:
1039:
1035:
1026:
991:Cystic fibrosis
918:
902:
898:
885:
729:
603:
597:
589:
584:
554:
549:
540:
494:
493:
489:
467:
466:
462:
455:
442:
441:
437:
432:
428:
418:
417:
413:
408:
401:
379:
378:
374:
367:
354:
353:
349:
305:
304:
300:
256:
255:
251:
221:
220:
216:
194:
193:
189:
182:
169:
168:
164:
160:
147:
123:corticosteroids
115:
85:
80:
72:beta-2 agonists
68:corticosteroids
17:
12:
11:
5:
1679:
1677:
1669:
1668:
1663:
1653:
1652:
1646:
1645:
1643:
1642:
1637:
1632:
1627:
1622:
1617:
1612:
1606:
1604:
1600:
1599:
1596:
1595:
1593:
1592:
1587:
1581:
1579:
1573:
1572:
1570:
1569:
1563:
1562:
1557:
1552:
1547:
1542:
1537:
1535:
1529:
1528:
1518:
1517:
1511:
1509:
1500:
1493:Pleural cavity
1489:
1488:
1485:
1484:
1481:
1480:
1478:
1477:
1472:
1471:
1470:
1465:
1455:
1449:
1447:
1443:
1442:
1439:
1438:
1436:
1435:
1430:
1425:
1420:
1415:
1409:
1407:
1401:
1400:
1398:
1397:
1392:
1386:
1384:
1380:
1379:
1377:
1376:
1371:
1366:
1360:
1358:
1354:
1353:
1351:
1350:
1349:
1348:
1339:
1325:
1320:
1319:
1318:
1308:
1307:
1306:
1301:
1296:
1286:
1285:
1284:
1279:
1269:
1263:
1261:
1254:
1240:
1234:
1233:
1230:
1229:
1227:
1226:
1221:
1216:
1211:
1206:
1205:
1204:
1194:
1185:
1180:
1175:
1169:
1167:
1163:
1162:
1160:
1159:
1158:
1157:
1155:Lycoperdonosis
1152:
1147:
1142:
1131:
1130:
1129:
1128:
1123:
1118:
1113:
1108:
1103:
1098:
1093:
1088:
1083:
1078:
1073:
1066:Pneumoconiosis
1062:
1060:
1045:
1028:
1027:
1025:
1024:
1019:
1018:
1017:
1007:
1002:
1000:
994:
993:
988:
986:Bronchiectasis
983:
982:
981:
976:
971:
962:
956:
946:
944:
938:
937:
932:
930:
924:
922:
908:
891:
890:
887:
886:
884:
883:
878:
873:
871:
863:
862:
857:
855:
847:
846:
841:
836:
831:
825:
823:
815:
814:
809:
803:
798:
796:Laryngeal cyst
793:
791:Laryngomalacia
788:
783:
781:
773:
772:
767:
761:
760:
759:
749:
747:
739:
737:
731:
730:
728:
727:
722:
717:
712:
710:
702:
701:
700:
699:
694:
689:
677:
672:
667:
666:
665:
660:
655:
645:
643:
635:
634:
629:
627:
619:
617:
608:
591:
590:
585:
583:
582:
575:
568:
560:
553:
552:
538:
487:
460:
453:
435:
426:
411:
409:Warrell, 1347.
399:
384:(in Russian).
372:
365:
347:
318:(4): 315–321.
298:
249:
214:
187:
180:
161:
159:
156:
146:
143:
114:
111:
84:
81:
79:
76:
51:Brittle asthma
46:
45:
42:
38:
37:
36:Asthma (lungs)
33:
32:
24:
23:
22:Brittle asthma
15:
13:
10:
9:
6:
4:
3:
2:
1678:
1667:
1664:
1662:
1659:
1658:
1656:
1641:
1638:
1636:
1633:
1631:
1628:
1626:
1623:
1621:
1618:
1616:
1613:
1611:
1608:
1607:
1605:
1603:Other/general
1601:
1591:
1588:
1586:
1585:Mediastinitis
1583:
1582:
1580:
1578:
1574:
1568:
1565:
1564:
1561:
1558:
1556:
1553:
1551:
1548:
1546:
1543:
1541:
1538:
1536:
1534:
1531:
1530:
1527:
1523:
1520:
1519:
1516:
1513:
1512:
1510:
1508:
1504:
1501:
1499:
1494:
1490:
1476:
1473:
1469:
1466:
1464:
1461:
1460:
1459:
1456:
1454:
1451:
1450:
1448:
1444:
1434:
1431:
1429:
1426:
1424:
1421:
1419:
1416:
1414:
1411:
1410:
1408:
1406:
1402:
1396:
1393:
1391:
1388:
1387:
1385:
1381:
1375:
1372:
1370:
1367:
1365:
1362:
1361:
1359:
1355:
1347:
1343:
1340:
1338:
1334:
1331:
1330:
1329:
1328:noninfectious
1326:
1324:
1321:
1317:
1314:
1313:
1312:
1309:
1305:
1302:
1300:
1297:
1295:
1292:
1291:
1290:
1287:
1283:
1280:
1278:
1275:
1274:
1273:
1270:
1268:
1265:
1264:
1262:
1258:
1255:
1253:
1248:
1244:
1241:
1237:Obstructive /
1235:
1225:
1222:
1220:
1217:
1215:
1212:
1210:
1207:
1203:
1200:
1199:
1198:
1195:
1193:
1189:
1186:
1184:
1181:
1179:
1176:
1174:
1171:
1170:
1168:
1164:
1156:
1153:
1151:
1150:Farmer's lung
1148:
1146:
1143:
1141:
1138:
1137:
1136:
1133:
1132:
1127:
1124:
1122:
1119:
1117:
1114:
1112:
1109:
1107:
1104:
1102:
1099:
1097:
1094:
1092:
1089:
1087:
1084:
1082:
1079:
1077:
1074:
1072:
1069:
1068:
1067:
1064:
1063:
1061:
1059:
1055:
1049:
1046:
1043:
1038:
1033:
1029:
1023:
1020:
1016:
1013:
1012:
1011:
1010:Bronchiolitis
1008:
1006:
1003:
1001:
999:
996:
995:
992:
989:
987:
984:
980:
977:
975:
972:
970:
966:
963:
960:
957:
955:
952:
951:
950:
947:
945:
943:
940:
939:
936:
933:
931:
929:
926:
925:
923:
921:
916:
912:
909:
906:
901:
896:
892:
882:
879:
877:
874:
872:
870:
869:
865:
864:
861:
858:
856:
854:
853:
849:
848:
845:
842:
840:
837:
835:
832:
829:
826:
824:
822:
821:
817:
816:
813:
810:
807:
804:
802:
799:
797:
794:
792:
789:
787:
784:
782:
780:
779:
775:
774:
771:
768:
765:
762:
758:
755:
754:
753:
750:
748:
746:
745:
741:
740:
738:
736:
732:
726:
723:
721:
718:
716:
713:
711:
709:
708:
704:
703:
698:
695:
693:
690:
688:
685:
684:
683:
682:
678:
676:
673:
671:
668:
664:
661:
659:
656:
654:
651:
650:
649:
646:
644:
642:
641:
637:
636:
633:
630:
628:
626:
625:
621:
620:
618:
616:
612:
609:
606:
601:
596:
592:
588:
581:
576:
574:
569:
567:
562:
561:
558:
547:
545:
543:
539:
534:
530:
525:
520:
515:
510:
506:
502:
498:
491:
488:
483:
479:
475:
471:
464:
461:
456:
450:
446:
439:
436:
430:
427:
422:
415:
412:
406:
404:
400:
395:
391:
387:
383:
376:
373:
368:
366:0-19-856978-5
362:
358:
351:
348:
343:
339:
334:
329:
325:
321:
317:
313:
309:
302:
299:
294:
290:
285:
280:
276:
272:
269:(4): 315–21.
268:
264:
260:
253:
250:
245:
241:
237:
233:
229:
225:
218:
215:
210:
206:
202:
198:
191:
188:
183:
181:1-85317-556-0
177:
173:
166:
163:
157:
155:
152:
144:
142:
140:
136:
132:
128:
124:
120:
112:
110:
108:
103:
101:
97:
92:
91:
82:
77:
75:
73:
69:
63:
61:
56:
53:is a type of
52:
43:
39:
34:
30:
25:
20:
1522:Pneumothorax
1475:Lung abscess
1457:
1327:
1316:Pneumocystis
1277:Pneumococcal
1058:lung disease
1054:occupational
1032:Interstitial
997:
941:
927:
900:lung disease
866:
860:Epiglottitis
850:
818:
812:Laryngospasm
776:
757:Strep throat
742:
705:
681:nasal septum
679:
638:
622:
507:(2): 102–5.
504:
500:
490:
476:(4): 135–8.
473:
469:
463:
444:
438:
429:
420:
414:
388:(3): 39–43.
385:
381:
375:
356:
350:
315:
311:
301:
266:
262:
252:
227:
223:
217:
200:
196:
190:
171:
165:
150:
148:
145:Epidemiology
127:beta agonist
116:
104:
88:
86:
64:
50:
49:
1620:Common cold
1567:Fibrothorax
1550:Chylothorax
1545:Hydrothorax
1498:mediastinum
1458:circulatory
1453:Atelectasis
1260:By pathogen
1252:pneumonitis
1239:Restrictive
1219:Sarcoidosis
1091:Berylliosis
1037:restrictive
998:unspecified
920:obstructive
903:(including
820:vocal cords
752:Pharyngitis
715:Tonsillitis
670:Nasal polyp
605:common cold
598:(including
230:(1): 40–4.
203:(1): 33–8.
1655:Categories
1540:Hemothorax
1342:Aspiration
1304:Chlamydiae
1294:Mycoplasma
1282:Klebsiella
1140:Bagassosis
1126:Byssinosis
1101:Chalicosis
1076:Asbestosis
1071:Aluminosis
1005:Bronchitis
876:Tracheitis
852:epiglottis
801:Laryngitis
675:Rhinorrhea
524:11383/8808
382:Ter. Arkh.
158:References
135:MedicAlert
41:Prevention
1615:Influenza
1560:Malignant
1323:Parasitic
1272:Bacterial
1247:Pneumonia
1116:Silicosis
1111:Siderosis
1081:Baritosis
915:Bronchial
663:Hay fever
632:Sinusitis
113:Treatment
87:The 2005
78:Diagnosis
1630:COVID-19
1423:BOOP-COP
1390:Broncho-
1333:Chemical
1121:Talcosis
1042:fibrosis
895:Lower RT
648:Rhinitis
595:Upper RT
533:17695694
482:15636398
394:18441682
244:15222953
209:11370504
100:wheezing
942:chronic
868:trachea
744:pharynx
624:sinuses
342:9741378
333:1745199
293:9741378
284:1745199
96:dyspnea
60:trigger
1661:Asthma
1311:Fungal
965:Asthma
778:larynx
707:tonsil
531:
480:
451:
392:
363:
340:
330:
312:Thorax
291:
281:
263:Thorax
242:
207:
178:
55:asthma
1446:Other
1395:Lobar
1346:Lipid
1267:Viral
1166:Other
928:acute
905:LRTIs
830:(LPR)
808:(LPR)
786:Croup
766:(LPR)
600:URTIs
83:Types
1625:SARS
1428:NSIP
1173:ARDS
974:AERD
949:COPD
735:Neck
640:nose
615:Head
529:PMID
478:PMID
449:ISBN
390:PMID
361:ISBN
338:PMID
289:PMID
240:PMID
205:PMID
176:ISBN
1418:DIP
1413:UIP
1405:IIP
519:hdl
509:doi
328:PMC
320:doi
279:PMC
271:doi
232:doi
98:),
1657::
1433:RB
541:^
527:.
517:.
505:67
503:.
499:.
472:.
402:^
386:80
336:.
326:.
316:53
314:.
310:.
287:.
277:.
267:53
265:.
261:.
238:.
226:.
201:43
199:.
141:.
74:.
1524:/
1495:/
1344:/
1335:/
1249:/
1190:/
1044:)
1040:(
1034:/
967:(
961:)
917:/
907:)
897:/
607:)
602:,
579:e
572:t
565:v
535:.
521::
511::
484:.
474:8
457:.
396:.
369:.
344:.
322::
295:.
273::
246:.
234::
228:5
211:.
184:.
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