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Anti IgE antibody as treatment of allergic bronchopulmonary aspergillosis in a patient with cystic fibrosis.
[allergic bronchopulmonary aspergillosis]
Allergic
bronchopulmonary
aspergillosis
(
ABPA
)
occurs
in
7
-
9
%
of
patients
with
cystic
fibrosis
(
CF
)
and
causes
a
worsening
of
lung
function
and
respiratory
symptoms
.
Standard
treatment
of
ABPA
consists
of
oral
steroids
;
however
,
higher
corticosteroid
therapy
associated
to
antifungal
agent
(
itraconazole
)
long
-term
treatments
are
often
required
to
reduce
respiratory
exacerbations
and
to
prevent
progressive
lung
damage
.
Here
we
describe
the
case
of
a
girl
with
CF
who
experienced
clinical
and
functional
improvement
over
12
-
months
treatment
with
omalizumab
.
At
birth
,
our
patient
was
diagnosed
with
mild
-
to
-
moderate
CF
and
from
childhood
she
underwent
annual
cycles
of
antibiotic
and
corticosteroid
therapies
.
At
12
years
,
she
presented
with
a
worsening
respiratory
condition
,
asthma
symptoms
and
reduced
lung
function
(
FEV
1
of
78
%
)
.
Blood
tests
showed
an
increased
concentration
of
plasma
total
IgE
and
positive
specific
IgE
antibodies
to
Aspergillus
fumigatus
;
allergic
skin
tests
were
also
positive
for
A
.
fumigatus
.
The
patient
started
steroid
therapy
but
had
impaired
glucose
tolerance
due
to
long
-term
steroid
use
.
Subcutaneous
omalizumab
300
mg
every
two
weeks
was
initiated
and
after
14
weeks
she
had
improved
respiratory
symptoms
(
FEV
1
99
%
)
and
a
marked
reduction
in
the
use
of
systemic
antibiotic
and
corticosteroid
therapies
.
No
side
effects
were
reported
.
Our
case
shows
that
therapy
with
omalizumab
for
a
prolonged
period
can
resolve
symptoms
of
asthma
.
Diseases
Validation
Diseases presenting
"asthma"
symptom
allergic bronchopulmonary aspergillosis
cutaneous mastocytosis
erdheim-chester disease
familial hypocalciuric hypercalcemia
lamellar ichthyosis
lymphangioleiomyomatosis
pendred syndrome
This symptom has already been validated
