Chest
Clinical InvestigationsMarked Goblet Cell Hyperplasia with Mucus Accumulation in the Airways of Patients Who Died of Severe Acute Asthma Attack
Section snippets
MATERIALS AND METHODS
Autopsied lungs from eight patients with BA and four control patients from the past five yr were chosen for the present morphometric study. Clinical and laboratory data from the patients are shown in Table 1. Control lungs were obtained from four patients who died of nonrespiratory diseases, two of whom died of sudden coronary disease and two of whom died of cancer of the digestive tract (one female and three male patients; mean age, 64 ±4 yr [±SE]). All were clinically free of respiratory
RESULTS
A larger amount of mucus in the lumen was observed with the marked hyperplasia of goblet cells in the airways from patients in group A compared with those in groups B and NL. A representative light micrograph of a peripheral airway from a patient with BA in group A is shown in Figure 1.
No significant differences in the diameters of the central or peripheral airways were observed among the three groups. In central airways the diameter was 3.3 ±0.3 mm, 2.7 ±0.3 mm, and 3.1 ±0.3 mm in groups A, B,
DISCUSSION
In the present study, we found marked goblet cell hyperplasia with accumulation of mucus in the peripheral airways from patients who died of severe acute asthma attack.
The heterogeneity of the asthmatic population is known, as well as the type of death and the postmortem findings. Although increased production of viscid mucus causing airway plugging is known to be a common pathologic feature of deaths from asthma,4, 5, 6, 7 in some patients, sudden unexpected death occurs with the absence of
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Manuscript received April 25; revision accepted July 1.