Kawasaki Yasutaka, Nishiki Kazuaki, Ishizaki Takeshi
Department of Internal Medicine, Wajima Municipal Hospital, Wajima-shi, Japan.
Department of Respiratory Medicine, Kanazawa Medical University, Kahoku-gun, Japan.
Respir Med Case Rep. 2023 Dec 16;47:101964. doi: 10.1016/j.rmcr.2023.101964. eCollection 2024.
A 67-year-old woman with a history of poorly controlled asthma was admitted to our hospital with a persistent cough and abnormal chest radiographic findings. Her diagnosis was allergic bronchopulmonary aspergillosis (ABPA). Following treatment with mepolizumab, her symptoms and imaging findings improved initially. However, after approximately 2 years, the patient experienced a recurrent cough with elevated non-specific immunoglobulin E levels and worsening chest imaging findings, thereby changing her diagnosis to recurrent ABPA. Mepolizumab was substituted with dupilumab, and her subjective symptoms and imaging findings improved. Our findings suggest that dupilumab may be effective in ABPA cases following the failure of another antibody therapy.
一名67岁女性，有哮喘控制不佳病史，因持续咳嗽和胸部影像学检查异常入住我院。她被诊断为变应性支气管肺曲霉病（ABPA）。使用美泊利单抗治疗后，她的症状和影像学表现最初有所改善。然而，大约2年后，患者出现复发性咳嗽，非特异性免疫球蛋白E水平升高，胸部影像学表现恶化，从而将诊断改为复发性ABPA。美泊利单抗换用度普利尤单抗后，她的主观症状和影像学表现得到改善。我们的研究结果表明，在另一种抗体治疗失败后的ABPA病例中，度普利尤单抗可能有效。
