Allergic bronchopulmonary aspergillosis (ABPA) is an immune-mediated inflammatory airway disease that predominantly affects patients with
cystic fibrosis (CF) and, less commonly, patients with
asthma. ABPA can lead to irreversible
lung injury and
bronchiectasis if not treated early and aggressively. Long-term oral
steroids are the standard
therapy of ABPA. However, it is associated with an increased risk of
steroids side effects and possible medication noncompliance. Monthly intravenous pulse
methylprednisolone (IV-PS) has been used as an alternative to oral
steroids to treat CF-related ABPA with a reportedly similar clinical response and less
steroid-related side effects. To our knowledge, the use of IV-PS in
asthma-related ABPA has not been previously reported. We report the successful management of
asthma-related ABPA in an adolescent using intravenous pulse
methylprednisolone in addition to oral
itraconazole with no significant
steroid-related side effects.