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 .

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allergic bronchopulmonary aspergillosis

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