Abstract
Glucocorticosteroid anti-inflammatory therapy has reliable effect in majority of patients with bronchial asthma. CKS lowers production of key mediators and cytokines of allergic inflammation in T-lymfocytes and other respiratory cells.
Approximately 5% of asthmatics do not respond well to effect of CKS and their asthma can be described as difficult-to-control. Taking care of these patients consumes a substantial proportion of financial and health resources.
Clinical phenotype of difficult-to-control asthma is not unified. Many alternative approaches with potential steroid-sparing effect were clinically applied.
However clinical studies with methotrexate, gold, cyclosporin A and intravenous immunoglobulin (IVIG) proved some effects, but serious sides effects could appear. IVIG therapy is well tolerated and its effect could be beneficial especially in most severe patients.
Authors present a case-report of young patient with corticosteroid-resistant bronchial asthma.