Allergic Bronchopulmonary Aspergillosis, Idiopathic Anaphylaxis, and Cystic Fibrosis in a 9-Year-Old Girl: A Case Report

We present a case of a 10-year-old white female with cystic fibrosis (CF), allergic bronchopulmonary aspergillosis (ABPA), and idiopathic anaphylaxis (IA). This patient was diagnosed with CF in infancy by a sweat test. She was referred to our clinic at age 9 years to consider a diagnosis of ABPA. The initial history was suggestive of ABPA but also revealed recurrent life-threatening episodes of upper airway obstruction. Based on her history and medical records, she was diagnosed with IA-generalized-frequent (IA-G-F) and managed with the IA protocol. A dramatic response to this management resulted first in control and then induction of a remission of IA or conversion to IA-G-Infrequent (IA-G-I). She was also diagnosed with ABPA central bronchiectasis (ABPA-CB), Stage II by history, serial serologic studies, and high resolution chest CAT scan. Although ABPA is well described in association with CF, we present the first case, to our knowledge, of CF, ABPA, and IA in one individual with control of the ABPA and IA.