[A case of effective readministration of itraconazole for recurrent allergic bronchopulmonary aspergillosis].
A 67-year-old woman suffered from productive cough but not from bronchial asthma. Her peripheral blood showed eosinophilia, a high serum level of total immunoglobulin E (IgE), and elevated specific IgE and positive precipitating antibody against Aspergillus fumigatus. Her chest radiograph and computed tomography revealed infiltrative shadows but not central bronchiectasis. Fibreoptic bronchoscopy detected some mucous plugs which grew Aspergillus fumigatus on culture. We therefore made a diagnosis of allergic bronchopulmonary aspergillosis (ABPA). We treated her using only itraconazole. Her respiratory symptoms, eosinophilia, serum IgE level, and pulmonary infiltration gradually improved, but withdrawal of itraconazole exacerbated her respiratory symptom and laboratory data. Administration of itraconazole again resulted in improvement of her symptoms and laboratory data. We report a case of ABPA without bronchial asthma or central bronchiectasis and refer to our diagnostic rationale. Furthermore, we discuss the decrease of allergens by the eradication of Aspergillus fumigatus in the airway with itraconazole to reduce the allergic reaction and improve the clinical symptoms.
Uji
Masato
M
Department of Internal Medicine, Izumi City Hospital.
Sugama
Yoshimi
Y
Nishida
Keiko
K
Matsushita
Haruhiko
H
D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000000981:diagnostic imaging / Q000188:drug therapy*; D001232:Aspergillus fumigatus / Q000276:immunology / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D017964:Itraconazole / Q000627:therapeutic use*; D013902:Radiography, Thoracic; D012008:Recurrence; D014057:Tomography, X-Ray Computed
D000935:Antifungal Agents; D017964:Itraconazole; D007073:Immunoglobulin E