Department of Respiratory Medicine, Nagasaki University Hospital, Japan.
Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan.
Intern Med. 2024 Jun 1;63(11):1659-1664. doi: 10.2169/internalmedicine.2234-23. Epub 2023 Oct 27.
Allergic bronchopulmonary aspergillosis (ABPA) and chronic pulmonary aspergillosis (CPA) are diseases caused by Aspergillus infection, and CPA can develop from ABPA in some cases. We herein report a patient with CPA overlapping with ABPA. Serum cytokine levels were evaluated at 4 time points: the ABPA diagnosis, CPA diagnosis, 6 months after the start of voriconazole (VRCZ), and 12 months after re-administration of VRCZ. Interleukin (IL)-13 levels decreased upon glucocorticoid treatment, whereas IL-25 and IL-33 levels decreased rapidly with the initiation of antifungals. Early antifungal therapy may be important to control disease progression and prevent CPA overlap.
变应性支气管肺曲霉病(ABPA)和慢性肺曲霉病(CPA)是由曲霉属感染引起的疾病,在某些情况下,CPA 可由 ABPA 发展而来。本文报告了一例重叠性 ABPA 和 CPA 的患者。在 4 个时间点评估了血清细胞因子水平:ABPA 诊断、CPA 诊断、伏立康唑(VRCZ)开始治疗 6 个月和 VRCZ 再次给药 12 个月。糖皮质激素治疗可降低白细胞介素(IL)-13 水平,而 IL-25 和 IL-33 水平在开始抗真菌治疗后迅速下降。早期抗真菌治疗可能对控制疾病进展和预防重叠性 CPA 非常重要。