Successful treatment with mepolizumab in a case of allergic bronchopulmonary aspergillosis complicated with nontuberculous mycobacterial infection
| Autor: | Mariko Miura, Nobuhiro Matsumoto, Hironobu Tsubouchi, Kenjiro Sakaguchi, Shinpei Tsuchida, Masamitsu Nakazato, Shigehisa Yanagi, Takafumi Shigekusa |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
Exacerbation Itraconazole medicine.drug_class Case Report 03 medical and health sciences 0302 clinical medicine Allergic bronchopulmonary aspergillosis Medicine Mepolizumab Asthma lcsh:RC705-779 business.industry lcsh:Diseases of the respiratory system medicine.disease 030228 respiratory system Nontuberculous mycobacterial infection 030220 oncology & carcinogenesis Exhaled nitric oxide Immunology Corticosteroid Formoterol business medicine.drug |
| Zdroj: | Respiratory Medicine Case Reports, Vol 28, Iss, Pp-(2019) Respiratory Medicine Case Reports |
| ISSN: | 2213-0071 |
| Popis: | Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity reaction that is associated with an allergic immunological response to Aspergillus species via Th2-related inflammation. The long-term use of a systemic corticosteroid is often needed for the treatment of ABPA. However, systemic corticosteroid treatment imposes a risk of the onset of a nontuberculous mycobacterial infection. Here we report the case of a patient with ABPA who required the long-term use of an oral corticosteroid because her repeated asthmatic attacks were successfully treated with mepolizumab, an anti-interleukin-5 monoclonal antibody. The patient, a 60-year-old Japanese female, had been treated with an oral corticoid and itraconazole. Despite the success of the initial treatment for ABPA, it was difficult to discontinue the use of the oral corticosteroid. In addition, Mycobacterium avium was detected from her bronchial lavage. We initiated mepolizumab treatment to taper the amount of corticosteroid and control the asthma condition. The patient's number of blood eosinophils, serum IgE level, fractional exhaled nitric oxide level, dosage of oral prednisolone, and need for inhaled budesonide/formoterol all improved, without an exacerbation of her asthma attacks. Although further research regarding mepolizumab treatment is needed, we believe that mepolizumab could be considered one of the agents for treating refractory ABPA. Keywords: Allergic bronchopulmonary aspergillosis, Nontuberculous mycobacterial infection, Mepolizumab, Asthma |
| Databáze: | OpenAIRE |
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