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Development of Chronic Airway Obstruction in Patients With Eosinophilic Bronchitis^*

A Prospective Follow-up Study

^* From the Asthma and Allergy Research Group, Soonchunhyang University Hospital, Bucheon, Korea.

Correspondence to: Choon-Sik Park, MD, Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, 1174, Jung Dong, Wonmi Ku, Bucheon, Gyeonggi Do, 420–021, Korea; e-mail: mdcspark{at}unitel.co.kr

Study objectives: Eosinophilic bronchitis (EB) presents as a chronic cough and sputum eosinophilia without airflow limitation or bronchial hyperreactivity. Its long-term clinical course remains unknown. This study evaluated how frequently EB recurs and whether it develops chronic airway obstruction.

Design: This study was a prospective analysis.

Methods: Cough severity, FEV₁, provocative concentration of methacholine causing a 20% fall in FEV₁, and sputum eosinophil percentages were serially measured in 36 subjects for up to 48 months. All subjects inhaled corticosteroids until cough subsided.

Results: Five of the twenty four follow-up subjects (21%) had a recurrent episode of EB 4 to 6 months after disappearance of the first episode of EB (recurrent eosinophilic bronchitis). Progressive FEV₁ reduction > 20% was observed in three of the subjects, including a subject with asthma developing at the ninth month. Nineteen subjects had no recurrence of cough (nonrecurrent eosinophilic bronchitis) and no progressive FEV₁ reduction > 20%. However, sputum eosinophilia recurred between 4 months and 24 months in 10 subjects. Mean values of FEV₁ at the ninth and 12th months of the study were significantly lower in the recurrent eosinophilic bronchitis group than in the nonrecurrent eosinophilic bronchitis group (p < 0.01).

Conclusion: These results suggest that repeated episode of EB is associated with the development of chronic airflow obstruction, including asthma.

Key Words: asthma • bronchitis • chronic airflow obstruction • eosinophil • sputum

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