Abstract：
Allergic bronchopulmonary aspergillosis (ABPA) is a lung disease characterized by a hypersensitivity reaction to Aspergillus fumigatus. Allergic bronchopulmonary aspergillosis is characterized by increased serum IgE levels, peripheral blood eosinophilia and radiographic pulmonary infiltrates, central bronchiectasis, and mucus plugs. Mepolizumab, a monoclonal interleukin (IL)-5 antibody, reduces eosinophilic inflammation and improves symptom control in severe eosinophilic asthma. A 74-year-old male patient arrived at our allergy outpatient clinic complaining of shortness of breath and cough. He had a history of asthma, NSAIDs Exacerbated Respiratory Disease (N-ERD) and endoscopic sinus surgery (ESS) due to chronic sinusitis with nasal polyps (CRSwNPs). At the time of admission to our clinic, his asthma control test (ACT) score was 5. The laboratory test results= eosinophil count (cells/mcL)= 570, total IgE= 3976 IU/mL, Aspergillus-specific IgE= 1.87 kIU/L (>0.35 positive). In the pulmonary function tests, forced expiratory volume in 1s (FEV1) was 28%. Thoracic computed tomography of the patient revealed central cystic bronchiectatic areas and mucus plugs. The patient was diagnosed with ABPA. The case reported here is of a patient diagnosed with severe asthma concomitant with ABPA and N-ERD, who was successfully treated with mepolizumab. Randomized double-blind placebo-controlled studies are needed to evaluate the efficacy of mepolizumab treatment in these patients.
摘要：
过敏性支气管肺曲霉病（ABPA）是一种以烟曲霉超敏反应为特征的肺部疾病。过敏性支气管肺曲霉病的特征是血清IgE水平升高，外周血嗜酸性粒细胞增多和影像学肺浸润，中央支气管扩张,和粘液塞。美泊利单抗,单克隆白细胞介素（IL）-5抗体，在严重的嗜酸性粒细胞性哮喘中,可减少嗜酸性粒细胞性炎症并改善症状控制.一名74岁的男性患者来到我们的过敏门诊诊所，抱怨呼吸急促和咳嗽。他有哮喘病史,由于慢性鼻窦炎伴鼻息肉（CRSwNP），NSAIDs加剧了呼吸系统疾病（N-ERD）和内窥镜鼻窦手术（ESS）。在进入我们诊所的时候，他的哮喘控制测试（ACT）得分为5分。实验室检测结果=嗜酸性粒细胞计数（细胞/mcL）=570，总IgE=3976IU/mL，曲霉特异性IgE=1.87kIU/L(>0.35阳性)。在肺功能测试中，1秒用力呼气量(FEV1)为28%。患者的胸部计算机断层扫描显示中央囊性支气管扩张区和粘液栓。患者被诊断为ABPA。这里报道的病例是一名被诊断患有严重哮喘并伴有ABPA和N-ERD的患者。他成功接受了美泊利单抗治疗。需要随机双盲安慰剂对照研究来评估美泊利单抗治疗在这些患者中的疗效。
