PDF(Pubmed)
Abstract：
Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus fumigatus that occurs in patients with asthma or cystic fibrosis. Here, we report a case of a young female with bronchial asthma who presented to our hospital with worsening breathlessness on exertion. She was diagnosed to have ABPA and was initiated on oral itraconazole while continuing inhaled long acting beta-2 adrenergic agonist and medium dose inhaled corticosteroid (ICS) for her asthma. Three months after initiation of therapy, the patient had significant improvement in breathlessness. However, she had weight gain, facial puffiness, increased facial hair and development of striae on her inner thighs, calf and lower abdomen. Her serum cortisol levels were found to be suppressed and hence a diagnosis of iatrogenic Cushing\'s syndrome was made. Our case describes the potentially serious interaction between ICS and oral itraconazole, a treatment very commonly prescribed in patients with ABPA.
摘要：
过敏性支气管肺曲霉病（ABPA）是对烟曲霉的超敏反应，发生在哮喘或囊性纤维化患者中。这里,我们报告了一例年轻女性支气管哮喘患者，她因劳累而出现呼吸困难。她被诊断为患有ABPA，并开始口服伊曲康唑，同时继续吸入长效β-2肾上腺素能激动剂和中等剂量吸入皮质类固醇（ICS）治疗哮喘。治疗开始三个月后,患者的呼吸困难有了显著改善.然而,她体重增加了,面部浮肿，增加面部毛发和大腿内侧条纹的发育，小腿和小腹。发现她的血清皮质醇水平受到抑制，因此诊断为医源性库欣综合征。我们的案例描述了ICS和口服伊曲康唑之间潜在的严重相互作用，ABPA患者中非常常见的治疗方法。
