Sobreposição de asma brônquica e DPOC

Immunoglobulin quantification showed an increase in total IgE levels (671 IU/mL), with no other abnormalities. Alpha-1 antitrypsin levels were normal. Respiratory function test results revealed moderately severe obstructive lung disease accompanied by inflation, moderately reduced alveolar-capillary diffusion, and mild type I respiratory failure. The patient had a negative bronchodilator response (Table 1). Her electrocardiogram was normal, and the results of the microbiological study of sputum were negative. The final diagnosis was uncontrolled bronchial asthma, pulmonary emphysema, diffuse bronchiectasis, and gastroesophageal reflux disease (GERD). The patient attributed her hypopharyngeal pain to the use of inhaled corticosteroids and therefore decided to discontinue the medication, having consequently shown improvement. She was started on esomeprazole, and salmeterol was replaced by indacaterol. Although this improved her pharyngeal and epigastric pain, she still had To the Editor: