To the Editor:
A 35-yr-old Asian nonsmoking housewife was seen in the asthma clinic in September 2006 with cough and haemoptysis. Her past history included atopic brittle asthma [1] since childhood with two intensive care unit (ICU) admissions in the past requiring mechanical ventilation, the latest being 1 month previously.
She was on maximal treatment for her asthma, and had recently been admitted to the ICU in June–August 2006, initially with an exacerbation of asthma with bilateral pneumothoraces, subsequently complicated by sepsis and acute respiratory distress syndrome. She was slow to wean from the ventilator and required a mini-tracheostomy for 19 days. In the period following discharge, she had been reviewed weekly in the clinic. She complained of a dry cough and dyspepsia, which was treated with a proton pump …