title: Intravenous monthly pulse methylprednisolone treatment for ABPA in patients with cystic fibrosis.
abstract: BACKGROUND
  Allergic bronchopulmonary aspergillosis (ABPA) in patients with CF is associated with frequent exacerbations and deterioration of lung function. Oral corticosteroids are standard therapy for ABPA and are associated with severe side effects. Monthly pulses of high-dose intravenous methylprednisolone (HDIVPM) are an effective therapy for autoimmune diseases with fewer side effects compared to oral prednisone, implicating its use for patients with CF who suffer from ABPA.
  
  
  METHODS
  9 patients with CF and ABPA (4 male, 5 female, ages 7-36 years) received HDIVPM (10-15 mg/kg/d), for 3 days per month, and itraconazole, until clinical and laboratory resolution of ABPA.
  
  
  RESULTS
  All patients showed clinical and laboratory improvement (FEV(1) increase, serum IgE levels and total eosinophil counts decrease) and treatment was discontinued after 6-10 pulses. Adverse effects were minor and disappeared shortly after each IV pulse therapy.
  
  
  CONCLUSIONS
  High-dose IV-pulse methylprednisolone is an effective treatment for ABPA in CF with minor side effects.
authors.affiliation: CF Centers of Hadassah Medical Center, Mount Scopus, Jerusalem, Israel.
authors.forename: Malena
authors.initials: M
authors.lastname: Cohen-Cymberknoh
authors.forename: Hannah
authors.initials: H
authors.lastname: Blau
authors.forename: David
authors.initials: D
authors.lastname: Shoseyov
authors.forename: Meir
authors.initials: M
authors.lastname: Mei-Zahav
authors.forename: Ori
authors.initials: O
authors.lastname: Efrati
authors.forename: Shoshana
authors.initials: S
authors.lastname: Armoni
authors.forename: Eitan
authors.initials: E
authors.lastname: Kerem
mesh_terms: D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000935:Antifungal Agents / Q000008:administration & dosage; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D017964:Itraconazole / Q000008:administration & dosage; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D020551:Pulse Therapy, Drug; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D000935:Antifungal Agents; D017964:Itraconazole; D008775:Methylprednisolone