Allergic bronchopulmonary aspergillosis successfully treated with mepolizumab: Case report and review of the literature

A 56-year-old woman was referred to our hospital for recurrent asthma of 20 years duration. She was diagnosed as having allergic bronchopulmonary aspergillosis on the basis of clinical symptoms, peripheral blood eosinophilia, elevated total serum immunoglobulin E value, positive results of specific...

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Main Authors: Shuko Hirota, Yoichi Kobayashi, Takashi Ishiguro, Takashi Nishida, Naho Kagiyama, Yoshihiko Shimizu, Noboru Takayanagi
Format: Article
Language:English
Published: Elsevier 2019-01-01
Series:Respiratory Medicine Case Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S2213007118303368
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spelling doaj-72a8340d77db4a2cb9218032573e1bd32020-11-25T00:53:56ZengElsevierRespiratory Medicine Case Reports2213-00712019-01-01265962Allergic bronchopulmonary aspergillosis successfully treated with mepolizumab: Case report and review of the literatureShuko Hirota0Yoichi Kobayashi1Takashi Ishiguro2Takashi Nishida3Naho Kagiyama4Yoshihiko Shimizu5Noboru Takayanagi6Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan; Corresponding author.Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, JapanDepartment of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, JapanDepartment of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, JapanDepartment of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, JapanDepartment of Pathology, Saitama Cardiovascular and Respiratory Center, JapanDepartment of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, JapanA 56-year-old woman was referred to our hospital for recurrent asthma of 20 years duration. She was diagnosed as having allergic bronchopulmonary aspergillosis on the basis of clinical symptoms, peripheral blood eosinophilia, elevated total serum immunoglobulin E value, positive results of specific IgE and precipitating antibodies against Aspergillus sp., central bronchiectasis, and mucoid impaction. Systemic corticosteroids and anti-fungal therapy improved her symptoms, but the cessation of these treatments led to frequent exacerbations. Omalizumab improved her asthmatic symptoms to the point that corticosteroids could be stopped; however, radiological findings were not improved, and coexisting eosinophilic sinusitis and otitis media worsened. After her treatment was changed from omalizumab to mepolizumab, not only her asthmatic symptoms but also her sinusitis and otitis media became well controlled, and chest radiological findings improved. Keywords: Allergic bronchopulmonary aspergillosis, Omalizumab, Mepolizumab, Corticosteroid, Itraconazolehttp://www.sciencedirect.com/science/article/pii/S2213007118303368
collection DOAJ
language English
format Article
sources DOAJ
author Shuko Hirota
Yoichi Kobayashi
Takashi Ishiguro
Takashi Nishida
Naho Kagiyama
Yoshihiko Shimizu
Noboru Takayanagi
spellingShingle Shuko Hirota
Yoichi Kobayashi
Takashi Ishiguro
Takashi Nishida
Naho Kagiyama
Yoshihiko Shimizu
Noboru Takayanagi
Allergic bronchopulmonary aspergillosis successfully treated with mepolizumab: Case report and review of the literature
Respiratory Medicine Case Reports
author_facet Shuko Hirota
Yoichi Kobayashi
Takashi Ishiguro
Takashi Nishida
Naho Kagiyama
Yoshihiko Shimizu
Noboru Takayanagi
author_sort Shuko Hirota
title Allergic bronchopulmonary aspergillosis successfully treated with mepolizumab: Case report and review of the literature
title_short Allergic bronchopulmonary aspergillosis successfully treated with mepolizumab: Case report and review of the literature
title_full Allergic bronchopulmonary aspergillosis successfully treated with mepolizumab: Case report and review of the literature
title_fullStr Allergic bronchopulmonary aspergillosis successfully treated with mepolizumab: Case report and review of the literature
title_full_unstemmed Allergic bronchopulmonary aspergillosis successfully treated with mepolizumab: Case report and review of the literature
title_sort allergic bronchopulmonary aspergillosis successfully treated with mepolizumab: case report and review of the literature
publisher Elsevier
series Respiratory Medicine Case Reports
issn 2213-0071
publishDate 2019-01-01
description A 56-year-old woman was referred to our hospital for recurrent asthma of 20 years duration. She was diagnosed as having allergic bronchopulmonary aspergillosis on the basis of clinical symptoms, peripheral blood eosinophilia, elevated total serum immunoglobulin E value, positive results of specific IgE and precipitating antibodies against Aspergillus sp., central bronchiectasis, and mucoid impaction. Systemic corticosteroids and anti-fungal therapy improved her symptoms, but the cessation of these treatments led to frequent exacerbations. Omalizumab improved her asthmatic symptoms to the point that corticosteroids could be stopped; however, radiological findings were not improved, and coexisting eosinophilic sinusitis and otitis media worsened. After her treatment was changed from omalizumab to mepolizumab, not only her asthmatic symptoms but also her sinusitis and otitis media became well controlled, and chest radiological findings improved. Keywords: Allergic bronchopulmonary aspergillosis, Omalizumab, Mepolizumab, Corticosteroid, Itraconazole
url http://www.sciencedirect.com/science/article/pii/S2213007118303368
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