Severe Asthma ToolkitSevere Asthma Toolkit
HomeAboutSpecific PopulationsRegistriesContributorsContact
Twitter
  • What is Severe Asthma?
    • Overview
    • Definition
    • Prevalence & Burden
    • Pathophysiology
    • Symptoms
    • Severe Asthma Attacks / Exacerbations / Flare-ups
    • Asthma Phenotypes
  • Diagnosis & Assessment
    • Overview
    • Diagnosis Overview
    • Assessment Overview
    • Lung Function Assessments
    • Questionnaires
    • Allergy Assessments
    • Phenotyping
    • Bronchoscopy
    • Imaging
    • Occupational Asthma
  • Management
    • Overview
    • Asthma Education
      • About Severe Asthma
      • Asthma Pathophysiology
      • Medications Education
      • Self-Monitoring
      • Triggers
      • Review
    • Written Action Plans
    • Adherence
    • Inhaler Technique
    • Physical Activity & Exercise
    • Interdisciplinary Approach & Multidimensional Assessment
    • Referral
  • Medications
    • Overview
    • Relievers
    • Preventers / Controllers
    • Add-on Therapies
    • Monoclonal Antibodies
    • Bronchial Thermoplasty
  • Co-Morbidities
    • Overview
    • Pulmonary & Upper Airways
      • Allergic & Non-Allergic Rhinitis
      • Chronic Rhinosinusitis
      • Dysfunctional Breathing
      • Vocal Cord Dysfunction
      • Chronic Obstructive Pulmonary Disease
      • Bronchiectasis
      • Obstructive Sleep Apnoea
    • Extra-Pulmonary
      • Obesity
      • Anxiety & Depression
      • Gastro-oesophageal Reflux Disease (GORD)
      • Osteoporosis
      • Cardiovascular Disease & Metabolic Disease
  • Living with Severe Asthma
    • Overview
    • Daily Symptom Burden
    • Mental & Emotional Health
    • Intimacy & Relationships
    • Self-Management Support
    • Medication Use & Costs
    • Experience of Care
    • Experience of Asthma Attacks
    • Prognosis
  • Establishing a Clinic
    • Overview
    • Set-up
    • Staffing & Multidisciplinary Team Approach
    • Facilities
    • Delivery Approach
    • Tailored Referrals
    • Evaluation
    • Opportunities for Training & Research
    • Barriers & Hurdles
  • Paediatrics
    • Overview
    • Management in Paediatrics
    • Assessment in Paediatrics
    • Alternative Diagnosis & Co-Morbidities in Paediatrics
    • Psychosocial Issues in Paediatrics
    • Medications in Paediatrics
    • Asthma in the Adolescent Population
  • Resources
    • Overview
    • Clinic Recommendations
    • Infographics
    • Asthma Assessment Resources
    • Systematic & Multidimensional Assessment Resources
      • Airway Components
      • Comorbidity Components
      • Risk Factor Components
    • Translation & Implementation
    • Case Studies
    • Presentations
    • Videos
    • Relevant Links
    • Key References

Bronchoscopy

Home Diagnosis & Assessment Bronchoscopy
asthma bronchoscopy

Bronchoscopy in Severe Asthma

Bronchoscopy in severe asthma is predominantly indicated to rule out other causes of symptoms, particularly vocal cord dysfunction (VCD) – although nasendoscopy is usually adequate for this purpose, and endobronchial obstruction (e.g. foreign body, tumour or impacted mucus).

  • Biopsies of the central airways may show typical changes of severe asthma (e.g. thickened reticular basement membrane, submucosal eosinophils and lymphocytes). Basement membrane thickening is characteristic of asthma.
  • Other pathological changes (e.g. increased airway smooth muscle, increased vascularity, mast cell degranulation, increased mucous gland size) are difficult to accurately assess from a small number of proximal airway biopsies.
  • The distribution of the pathology of asthma in the bronchial tree is likely to be heterogeneous, which reduces the representativeness of small biopsy samples (Elliot et al. 2015).
  • Bronchoalveolar lavage for differential inflammatory cell counts will likely be of limited value and would not be an indication for bronchoscopy in severe asthma.
  • Transbronchial biopsy of the peripheral airways has shown inflammation and structural changes in the small airways. The representativeness of these samples is unclear and their usefulness in phenotyping individuals is yet to be established. The risks of pneumothorax or bleeding, although small, currently limit this application (James et al. 2002), except to help identify specific lesions or diseases (e.g. malignancy, sarcoidosis).
Previous
Next

Last Updated on February 11, 2019

Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories

More results...

  • Overview
  • Diagnosis Overview
  • Assessment Overview
  • Lung Function Assessments
  • Questionnaires
  • Allergy Assessments
  • Phenotyping
  • Bronchoscopy
  • Imaging
  • Occupational Asthma

We want to know who accesses the Severe Asthma Toolkit and how it is used. Please complete our survey.

Responses will inform the continued development of the Severe Asthma Toolkit and future translation and implementation activities. Any feedback you provide will be greatly appreciated.

Complete Survey

  • Website Terms of Use
  • Website Survey
© Copyright 2018    CRICOS Provider Number 00109J    The University of Newcastle, Australia