Prolonged evaluation of patients with corticosteroid-dependent asthma stage of allergic bronchopulmonary aspergillosis

Roy Patterson*, Paul A. Greenberger, Theodore M. Lee, Janice L. Liotta, Elizabeth A. O'Neill, Mary Roberts, Herbert Sommers

*Corresponding author for this work

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

Eight cases with stage IV allergic bronchopulmonary aspergillosis (ABPA) (corticosteroid-dependent asthma stage) were observed for a total of 82 patient years with individual patients observed for 7 to 19 years (mean 10.2) years. One case is the first case of ABPA diagnosed in the United States in 1967. A second case has been observed through four stages of ABPA. None of these eight cases has demonstrated pulmonary deterioration by clinical, chest roentgenogram, or pulmonary function analysis. After diagnosis, the maintenance dose of prednisone in seven of eight cases was a low to moderate dose alternate-day prednisone. These results suggest that continuous observation and management of episodes of pulmonary consolidation or asthma exacerbations may prevent the progression of ABPA to stage V (fibrotic end stage). The total IgE may remain elevated in these patients, and therapy should not attempt to reduce total serum IgE to normal levels. After prolonged therapy with prednisone for asthma and control of ABPA, the IgE and IgG antibody indices against Aspergillus fumigatus may remain elevated or may be below the levels that are of diagnostic value.

Original languageEnglish (US)
Pages (from-to)663-668
Number of pages6
JournalThe Journal of allergy and clinical immunology
Volume80
Issue number5
DOIs
StatePublished - Nov 1987

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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