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Complete withdrawal of glucocorticoids after dupilumab therapy in allergic bronchopulmonary aspergillosis:A case report

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World Journal of Clinical Cases 2021年第23期9卷 6922-6928页

作者： Tadashi Nishimura Tomohito Okano Masahiro Naito Chikashi Tsuji Soichi Iwanaka Yasumasa Sakakura Taro Yasuma Hajime Fujimoto Corina N D'Alessandro-Gabazza Yasuhiro Oomoto tetsu kobayashi Esteban C Gabazza Hidenori Ibata Department of Pulmonary Medicine Mie Chuo Medical CenterTsu 514-1101MieJapan Department of Pulmonary and Critical Care Medicine Mie UniversityTsu 514-8507MieJapan Department of Immunology Mie University School of MedicineMie UniversityTsu 514-8507MieJapan Department of Pulmonary and Critical Care Medicine Graduate School of Medicine MieMie UniversityTsu 514-8507MieJapan

BACKGROUND Allergic bronchopulmonary aspergillosis(ABPA)is an allergic reaction to Aspergillus species that aggravates bronchial *** studies demonstrated the glucocorticoid-sparing effect of dupilumab in patients with *** is no report of complete withdrawal of glucocorticoids after *** SUMMARY The patient was a 54-year-old woman with bronchial asthma treated with inhaled corticosteroids and a long-acting beta-2 *** consulted our institution for productive cough and fever in March *** computed tomography scan revealed mucoid impaction,and the bronchial lavage fluid culture was positive for Aspergillus *** diagnosis was *** patient was treated with oral glucocorticoids from April 2017 to November *** January 2019,she had bronchial asthma exacerbation,and a chest computed tomography scan showed recurrent mucoid *** was treated with oral glucocorticoids and *** February 2020,during tapering of oral glucocorticoid,she had the third episode of bronchial asthma exacerbation and a mucoid *** patient was treated with dupilumab in addition to oral glucocorticoid and *** clinical response improved,and oral glucocorticoid was discontinued in June *** This is the first case of ABPA in which complete withdrawal of glucocorticoid was possible after treatment with dupilumab.

关键词： Allergic bronchopulmonary aspergillosis Dupilumab Asthma Interleukin-13 Interleukin-4 Case report

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