Abstract:
Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity reaction to Aspergillus spp. ABPA diagnosis may be challenging due to its non-specific presentation. Standard ABPA treatment consists of systemic corticosteroids and antifungal agents. Mepolizumab, a monoclonal antibody against interleukin-5 seems to be a promising treatment for ABPA. Data about ABPA following lung transplantation (LuTx) are scarce. LuTx recipients are at higher risk for adverse effects of ABPA treatment compared to the general population. Here we present a case of a LuTx recipient who was successfully treated with mepolizumab for ABPA following LuTx. Prolonged administration of high dose prednisone was thus avoided. To our knowledge, this is the first case describing mepolizumab administration following LuTx. Mepolizumab seems particularly attractive as a corticosteroid-sparing agent or as an alternative option to antifungal treatments, because of its excellent safety profile and low risk of drug interactions.
摘要:
过敏性支气管肺曲霉病(ABPA)是对曲霉属的复杂超敏反应。由于其非特异性表现,ABPA诊断可能具有挑战性。标准ABPA治疗包括全身性皮质类固醇和抗真菌剂。美泊利单抗,抗白细胞介素-5的单克隆抗体似乎是ABPA的有希望的治疗方法.有关肺移植(Lutx)后ABPA的数据很少。与普通人群相比,Lutx接受者患ABPA治疗不良反应的风险更高。在这里,我们介绍了一个Lutx接受者的病例,他在Lutx后成功用美泊利单抗治疗ABPA。因此避免了长时间施用高剂量泼尼松。据我们所知,这是首次描述Lutx后给予美泊利单抗的病例.美泊利单抗作为皮质类固醇保护剂或作为抗真菌治疗的替代选择似乎特别有吸引力。由于其优异的安全性和低的药物相互作用风险。