Matsumoto Nobuhiro, Shigekusa Takafumi, Matsuo Ayako, Tsubouchi Hironobu, Yanagi Shigehisa, Nakazato Masamitsu
Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine University of Miyazaki Miyazaki Japan.
Respirol Case Rep. 2019 Jul 16;7(7):e00465. doi: 10.1002/rcr2.465. eCollection 2019 Oct.
A 67-year-old woman was admitted to our hospital because of frequent asthma attacks and refractory chronic rhinosinusitis. She was diagnosed with allergic bronchopulmonary aspergillosis (ABPA) concomitant with eosinophilic chronic rhinosinusitis (ECRS) on the basis of peripheral blood eosinophilia, precipitating antibodies against , elevated total serum IgE, pulmonary infiltration, central bronchiectasis, mucoid impaction, and bilateral rhinosinusitis with nasal polyps, which showed remarkable eosinophil accumulation histologically, especially in the ethmoid sinuses. Treatment with mepolizumab, 100 mg every 4 weeks, was initiated for both the ABPA and ECRS. Consistent with the decrease in the peripheral eosinophil count, the asthma and rhinosinusitis symptoms were drastically ameliorated. Not only her airway symptoms but also her exercise tolerance and pulmonary function test results remarkably improved. Mepolizumab therapy enhanced the quality of life for this patient with intractable ABPA and ECRS.
一名67岁女性因频繁哮喘发作和难治性慢性鼻-鼻窦炎入住我院。基于外周血嗜酸性粒细胞增多、针对曲霉菌的沉淀抗体、血清总IgE升高、肺部浸润、中心性支气管扩张、黏液嵌塞以及双侧鼻-鼻窦炎伴鼻息肉（组织学检查显示嗜酸性粒细胞显著积聚，尤其是在筛窦），她被诊断为变应性支气管肺曲霉菌病（ABPA）合并嗜酸性粒细胞性慢性鼻-鼻窦炎（ECRS）。开始每4周使用100 mg美泊利单抗治疗ABPA和ECRS。随着外周嗜酸性粒细胞计数的下降，哮喘和鼻-鼻窦炎症状显著改善。不仅她的气道症状，而且她的运动耐量和肺功能测试结果也明显改善。美泊利单抗治疗提高了这名患有难治性ABPA和ECRS患者的生活质量。
