Tezepelumab treatment for allergic bronchopulmonary aspergillosis.

Abstract

An 82-year-old man had been diagnosed with asthma. He experienced repeated exacerbations requiring treatment with a systemic corticosteroid despite being treated with medications including high-dose fluticasone furoate/umeclidinium/vilanterol, montelukast sodium, and theophylline; treatment with mepolizumab was then initiated. The patient had been free from exacerbations for 15 months; however, he suffered from post-obstructive pneumonia and atelectasis secondary to mucoid impaction in the right middle lobe of the lung, accompanied by a productive cough, wheezing, dyspnea, and right chest pain. In addition to the development of mucus plugs, the levels of serum IgE specific to Aspergillus spp. became positive; a definite diagnosis of allergic bronchopulmonary aspergillosis (ABPA) was established. The patient underwent treatment with tezepelumab. Over 3 months, the mucus plugs and pulmonary opacities diminished gradually in parallel with the improvement in the control of asthmatic symptoms. Tezepelumab might provide a novel steroid-sparing strategy for the management of ABPA, although further studies are required.

• Authors: Hiroaki Ogata, Kachi Sha, Yasuaki Kotetsu, Aimi Enokizu-Ogawa, Katsuyuki Katahira, Akiko Ishimatsu, Kazuhito Taguchi, Atsushi Moriwaki, Makoto Yoshida
• Journal: Respirology case reports (Respirol Case Rep) Vol. 11 Issue 5 Pg. e01147 (May 2023) ISSN: 2051-3380 [Print] United States
• PMID: 37082171 (Publication Type: Case Reports)
• Copyright: © 2023 The Authors. Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology.