A 70-year old female came to our clinic complaining uncontrolled asthma for 10 years. Spirometry showed obstructive lesion (FEV1=94.9%, FEV1/FVC =71.08%) with 5% bronchodilator (BD) response. PC20 of methacholine was 3.8 mg/ml. Chest CT showed diffuse bronchial wall thickening with tree in bud sign. Treated with clarithromycin for 1 month, FEV1was improved from 64.9% to 84.2% without asthma medication.
A 25-year old male with uncontrolled asthma. Initial FEV1 was 2.51 L (62.6%) and severe sputum eosinophilia. His CT scan shows diffuse bronchitis with tree bud sign and then treated with clarithromycin for 9 months. FEV1was improved from 62.6% to 88.4%. He reduced daily amount of inhaled corticosteroid.