A case of allergic bronchopulmonary mycosis: 3D‐CT Findings led to successful multidisciplinary treatment with dupilumab and cryoprobe
Abstract The present case involved a 78‐year‐old woman with repeated recurrences of allergic bronchopulmonary mycosis (ABPM) who presented to our outpatient clinic with a chief complaint of dyspnoea with respiratory failure. Computed tomography (CT) of the chest showed atelectasis of the lower lobes...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-02-01
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| Series: | Respirology Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/rcr2.1305 |
| _version_ | 1797295252522926080 |
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| author | Masamitsu Hamakawa Takafumi Yamano Machiko Arita Takashi Niwa Tadashi Ishida |
| author_facet | Masamitsu Hamakawa Takafumi Yamano Machiko Arita Takashi Niwa Tadashi Ishida |
| author_sort | Masamitsu Hamakawa |
| collection | DOAJ |
| description | Abstract The present case involved a 78‐year‐old woman with repeated recurrences of allergic bronchopulmonary mycosis (ABPM) who presented to our outpatient clinic with a chief complaint of dyspnoea with respiratory failure. Computed tomography (CT) of the chest showed atelectasis of the lower lobes due to mucus plugs. Blood and biochemical tests showed a high peripheral blood eosinophil count (1330/μL) and elevated immunoglobulin E (15,041 IU/mL; normal, < 361 IU/mL). Recurrent ABPM was diagnosed. The patient also showed chronic lower respiratory tract infection associated with Mycobacterium avium complex and Pseudomonas aeruginosa. First, we removed the mucus plug with a cryoprobe to avoid administering corticosteroids. However, subsequent 3‐dimensional CT showed residual mucus plugs, so we administered dupilumab as an additional treatment. After initiating dupilumab, mucus plugs disappeared and respiratory failure resolved. We were able to implement multidisciplinary treatment that did not rely on corticosteroids. |
| first_indexed | 2024-03-07T21:44:05Z |
| format | Article |
| id | doaj.art-09def855da2a4eba9888467f5905348b |
| institution | Directory Open Access Journal |
| issn | 2051-3380 |
| language | English |
| last_indexed | 2024-03-07T21:44:05Z |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Respirology Case Reports |
| spelling | doaj.art-09def855da2a4eba9888467f5905348b2024-02-26T01:02:44ZengWileyRespirology Case Reports2051-33802024-02-01122n/an/a10.1002/rcr2.1305A case of allergic bronchopulmonary mycosis: 3D‐CT Findings led to successful multidisciplinary treatment with dupilumab and cryoprobeMasamitsu Hamakawa0Takafumi Yamano1Machiko Arita2Takashi Niwa3Tadashi Ishida4Department of Respiratory Medicine Kurashiki Central Hospital Okayama JapanDepartment of Respiratory Medicine Kurashiki Central Hospital Okayama JapanDepartment of Respiratory Medicine Kurashiki Central Hospital Okayama JapanDepartment of Respiratory Medicine Kanagawa Cardiovascular and Respiratory Center Kanagawa JapanDepartment of Respiratory Medicine Kurashiki Central Hospital Okayama JapanAbstract The present case involved a 78‐year‐old woman with repeated recurrences of allergic bronchopulmonary mycosis (ABPM) who presented to our outpatient clinic with a chief complaint of dyspnoea with respiratory failure. Computed tomography (CT) of the chest showed atelectasis of the lower lobes due to mucus plugs. Blood and biochemical tests showed a high peripheral blood eosinophil count (1330/μL) and elevated immunoglobulin E (15,041 IU/mL; normal, < 361 IU/mL). Recurrent ABPM was diagnosed. The patient also showed chronic lower respiratory tract infection associated with Mycobacterium avium complex and Pseudomonas aeruginosa. First, we removed the mucus plug with a cryoprobe to avoid administering corticosteroids. However, subsequent 3‐dimensional CT showed residual mucus plugs, so we administered dupilumab as an additional treatment. After initiating dupilumab, mucus plugs disappeared and respiratory failure resolved. We were able to implement multidisciplinary treatment that did not rely on corticosteroids.https://doi.org/10.1002/rcr2.13053D‐CTABPMcryoprobedupilumabmucus plug |
| spellingShingle | Masamitsu Hamakawa Takafumi Yamano Machiko Arita Takashi Niwa Tadashi Ishida A case of allergic bronchopulmonary mycosis: 3D‐CT Findings led to successful multidisciplinary treatment with dupilumab and cryoprobe Respirology Case Reports 3D‐CT ABPM cryoprobe dupilumab mucus plug |
| title | A case of allergic bronchopulmonary mycosis: 3D‐CT Findings led to successful multidisciplinary treatment with dupilumab and cryoprobe |
| title_full | A case of allergic bronchopulmonary mycosis: 3D‐CT Findings led to successful multidisciplinary treatment with dupilumab and cryoprobe |
| title_fullStr | A case of allergic bronchopulmonary mycosis: 3D‐CT Findings led to successful multidisciplinary treatment with dupilumab and cryoprobe |
| title_full_unstemmed | A case of allergic bronchopulmonary mycosis: 3D‐CT Findings led to successful multidisciplinary treatment with dupilumab and cryoprobe |
| title_short | A case of allergic bronchopulmonary mycosis: 3D‐CT Findings led to successful multidisciplinary treatment with dupilumab and cryoprobe |
| title_sort | case of allergic bronchopulmonary mycosis 3d ct findings led to successful multidisciplinary treatment with dupilumab and cryoprobe |
| topic | 3D‐CT ABPM cryoprobe dupilumab mucus plug |
| url | https://doi.org/10.1002/rcr2.1305 |
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