The sputum finding of Curschmann's spirals and Charcot-Leyden crystals is associated with which stage of asthma?

• A. Severe asthma
• B. Mild intermittent asthma
• C. Chronic bronchitis
• D. Pulmonary fibrosis

Answer: (A)

These sputum findings reflect a prominent eosinophilic inflammatory response with mucus plugging in the airways, something seen most clearly in more severe, long-standing asthma. Curschmann's spirals are shed epithelial plugs from small airways, and Charcot-Leyden crystals come from eosinophil breakdown in the airway mucosa. Together, they indicate intense eosinophilic activity and mucus production typical of severe asthma. In milder intermittent disease, such extensive mucus plugging and eosinophilic turnover are less common; chronic bronchitis and pulmonary fibrosis involve different pathological processes and aren’t characterized by this combination of findings. Thus, these features are most consistent with severe asthma.