PT  - JOURNAL ARTICLE
AU  - Daniel Doberer
AU  - Humberto E. Trejo Bittar
AU  - Sally E. Wenzel
TI  - Should lung biopsies be performed in patients with severe asthma?
AID  - 10.1183/16000617.0045-2015
DP  - 2015 Sep 01
TA  - European Respiratory Review
PG  - 525--539
VI  - 24
IP  - 137
4099  - http://err.ersjournals.com/content/24/137/525.short
4100  - http://err.ersjournals.com/content/24/137/525.full
SO  - EUROPEAN RESPIRATORY REVIEW2015 Sep 01; 24
AB  - Asthma, and severe asthma, in particular, is increasingly recognised as a heterogeneous disease. Identifying these different phenotypes of asthma and assigning patients to phenotype-specific treatments is one of the current conundrums in respiratory medicine. Any diagnostic procedure in severe asthma (or any disease) should have two aims: 1) better understanding or identifying the diagnosis, and 2) providing information on the heterogeneity of asthma phenotypes to guide therapy with the objective of improving outcomes. Lung biopsies can target the large and small airways as well as the lung parenchyma. All compartments are affected in severe asthma; however, knowledge on the distal lung is limited. At this point, it remains uncertain whether lung specimens routinely add diagnostic information that is unable to be obtained otherwise. Indeed, whether a lung biopsy is indicated in the workup of a patient with severe asthma remains an individual decision. It is hoped this review will support rational decision-making and provide a detailed synopsis of the varied histopathological features seen in biopsies of patients with a diagnosis of severe asthma. Due to limited data on this topic this review is primarily based on opinion with recommendations arising primarily from the personal experience of the authors.Optimising use of lung biopsies in a diagnostic workup of severe asthma requires a multidisciplinary approach http://ow.ly/PdLW2