title: [Familial occurrence of bronchiolitis obliterans associated with pulmonary aspergillosis].
abstract: We report the familial occurrence of bronchiolitis obliterans (BO) associated with pulmonary aspergillosis. A mother and daughter admitted for dyspnea after taking Sauropus androgynus both had overfiltration of both lungs in chest X-ray and severe obstructive impairment in lung function tests. They were initially diagnosed with severe asthma and treated with high-dose prednisolone (0.5mg/kg/day) for 1 month to no effects. They did not show reversibility in lung function test. They were difinitively diagnosed with BO associated with Sauropus androgynus. Six months later, the mother's symptoms worsened with productive sputum and severe dyspnea, and her chest X-ray showed patty shadow in both upper lung fields. Precipitating antibodies to aspergillus antigen were positive and aspergillus fumigatus was detected from her sputum culture. She was diagnosed with aspergillosis and treatment with Micafungin (MCFG) and Itraconazole (ITCZ) was started. The daughter's symptoms also worsened and her chest tomography showed multiple cavities in both lung fields. Precipitating antibodies to aspergillus were positive. She was diagnosed with Invasive aspergillosis. She was treated unsuccessfully with MCFG and Amphotericin B (AMPH) and ITCZ. Few reports cover BO with aspergillus infection without organ impairment. In these 2 cases, treatment with steroids' or immune suppression of the lung with BO may a trigger aspergillus infection.
authors.affiliation: Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tagawa
authors.forename: Yuji
authors.initials: Y
authors.lastname: Watanuki
authors.forename: Miho
authors.initials: M
authors.lastname: Hayashi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shinohara
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Kenmotsu
authors.forename: Satoko
authors.initials: S
authors.lastname: Kozawa
authors.forename: Takahiro
authors.initials: T
authors.lastname: Endo
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Nishihira
authors.forename: Mari
authors.initials: M
authors.lastname: Nakamura
authors.forename: Takashi
authors.initials: T
authors.lastname: Ogura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
mesh_terms: D000328:Adult; D001228:Aspergillosis / Q000150:complications*; D001989:Bronchiolitis Obliterans / Q000150:complications*; D005190:Family; D005260:Female; D006801:Humans; D008172:Lung Diseases, Fungal / Q000150:complications*; D008875:Middle Aged