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It details the June 2018 presentation with breathlessness, cough, wheezing, and eye itching; bronchodilator response and clear chest X-ray; initial treatment with oral prednisone, albuterol inhaler, and Symbicort; subsequent deterioration with sleep disturbance, tachypnea, low oxygen saturation, and ABG showing reduced PaO2. It notes inpatient-like management with oxygen, albuterol, and hydrocortisone, and follow-up counseling on triggers and inhaler technique. 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