Patient With COPD-Asthma Overlap Detected by Sputum Eosinophilia

A 70-year-old man was diagnosed with COPD. He reported symptoms of nocturnal shortness of breath, cough and wheezing in the last time; however, he had never had asthma. Despite the treatment and the pulmonary rehabilitation, our patient referred the persistence of the symptoms. In a research screening of differential cellular count in the induced sputum in patients with COPD, we found that his sample showed high percentage of eosinophils. Due to this finding, we started to study him. Peripheral eosinophilia, FeNO and IgE were also found to be elevated. In the last years, he had chronic rhinitis. Besides, the reversibility of lung function after bronchodilators was observed. The algorithms to diagnose asthma-COPD overlap syndrome (ACOS) include positive bronchodilator response, sputum eosinophilia or previous diagnosis of asthma, high IgE and/or history of atopy. Our patient was diagnosed with ACOS, and the sputum findings have contributed to the modification of his treatment and lead to a clinical improvement and reduction of the symptoms. J Med Cases. 2015;6(12):544-546 doi: http://dx.doi.org/10.14740/jmc2348w