Bronchoconstriction Induced by Spirometric Maneuvers in a Male Patient: A Case Report.

Abstract

Spirometry-induced bronchoconstriction (SIB) refers to the paradoxical narrowing of the airways triggered by deep inhalation (DI) during spirometry testing. This response is atypical but can occur in subjects with heightened airway sensitivity, such as those with asthma. The present case report described a male patient who developed SBI in response to DI during spirometric maneuvers. A 34-year-old male patient with personal (i.e., rhinitis) and family allergy consulted our pulmonary department for recurrent wheezing dyspnea associated with exertional dyspnea level 2 according to the modified Medical Research Council dyspnea scale. Asthma diagnosis was suspected and a spirometry test was required. During five consecutive spirometric efforts, the patient developed a SIB with forced expiratory volume in one second (FEV₁) decreases (in mL and % of initial value [%_Initial]) of 50 mL (1%_Initial), 270 mL (8%_Initial), 480 mL (14%_Initial), and 600 mL (18%_Initial), respectively. Following the spirometry tests, the patient presented symptoms such as wheezing, shortness of breath, and chest tightness. The bronchodilator test (i.e., 400 µg of short-acting bronchodilator) was clinically significant with an increase of FEV₁ by 1,260 mL (40%_Predicted) (FEV₁ passed from 2.80 L [65%_Predicted] to 4.06 L [95%_Predicted]). An alleviation of symptoms was noted, which supports the diagnosis of SIB. Clinicians should exercise caution when asking asthmatic patients to repeatedly perform DI for spirometry testing.