After that, his condition improved and he was subsequently discharged. The treatment included Methylprednisolone at a daily dose of 40 mg intravenously and oral Theophylline 0.2 g once every 12 hours for 3 days. Upon referral, he was admitted to our hospital for further treatment. After receiving symptomatic treatment, the patient’s condition improved but did not normalize. Inflammation was observed in both bronchial trees on bronchoscopy. No abnormalities were noted in echocardiogram. The bronchodilator reversibility test was positive: FEV 1 increased >12% and >200 mL with inhaled Ventolin 400 µg ( Figure 1). Pulmonary function test suggested mild obstructive ventilatory dysfunction with FEV 1 at 72.2% of predicted, FVC at 89.7% of predicted, and FEV 1/FVC ratio at 66.81%. Chest CT scan showed interstitial inflammation in the right middle and left upper lobe. One month after the treatment, he suffered from an attack of wheezing during moderate activity and was admitted to a local hospital, in which he was diagnosed with ‘bronchial asthma’ and ‘type 2 respiratory failure’, from 1st December to 13th December 2012. His condition improved, but he still had occasional relapses. He was diagnosed with ‘upper respiratory infection’ in a local hospital and received symptomatic treatment for several days that he could not recall clearly. He had no chills, fever, chest pain, chest tightness, palpitations, night sweats, hemoptysis or paroxysmal nocturnal dyspnea. The cough was worse upon waking in the morning and laying down at night. The patient began to cough with white phlegm after a cold in 2012. A 43-year-old man was admitted to the Guangzhou Institute of Respiratory Disease (GIRD), the First Affiliated Hospital of Guangzhou Medical University because of recurrent episodes of coughing, expectoration and wheezing for 3 years with aggravation during the previous 6 months.
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