PMC7491355_01
Chest CT demonstrating pulmonary infiltrates, bipulmonary bronchiectasis and bronchial wall thickening consistent with ABPA
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Fig1
ABPA based on bronchiectasis and pulmonary infiltrates (Fig. 1), eosinophilia of 950/microl (13%), total serum IgE of up to 7000 IU/ml, specific aspergillus IgE of 31.4 U/ml and specific aspergillus IgG of more than 200 mg/l. A trial of itraconazol had been performed but was stopped due to inefficacy.
a Course of asthma control test (ACT) score and prednisolone dose over time. b Course of lung function parameters FEV1 and RV over time. c Course of FeNO, eosinophil count and IgE over time
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Fig2
Oral steroid medication had been tapered completely and the patient experienced improvements of former steroid side effects (Fig. 2a). FEV1-increase of almost 1000 ml to 3.43 l (99.6%), normalization of RV to 98% (Fig. 2b), and strong improvement in small airway obstruction (increase in MMEF from 1.76 to 2.87 l/s). FeNO decreased to a normal value of 10 ppb. Lung function improvements were sustained at 8 months follow-up (Fig. 2b). Eosinophils at 4 months follow-up were increased to 1056/microl (16%), however normalized to 200/microl at 8 months follow-up (Fig. 2c).