PMID- 30514257
OWN - NLM
STAT- MEDLINE
DCOM- 20190403
LR  - 20190403
IS  - 1471-2466 (Electronic)
IS  - 1471-2466 (Linking)
VI  - 18
IP  - 1
DP  - 2018 Dec 4
TI  - Recurrence of allergic bronchopulmonary aspergillosis after adjunctive surgery 
      for aspergilloma: a case report with long-term follow-up.
PG  - 185
LID - 10.1186/s12890-018-0743-0 [doi]
LID - 185
AB  - BACKGROUND: Coexistence of aspergilloma and allergic bronchopulmonary 
      aspergillosis (ABPA) has rarely been reported. Although the treatment for ABPA 
      includes administration of corticosteroids and antifungal agents, little is known 
      about the treatment for coexisting aspergilloma and ABPA. Furthermore, the impact 
      of surgical resection for aspergilloma on ABPA is not fully understood. Here, we 
      present an interesting case of recurrent ABPA with long-term follow-up after 
      surgical resection of aspergilloma. CASE PRESENTATION: A 53-year-old man with a 
      medical history of tuberculosis was referred to our hospital with cough and 
      dyspnea. Imaging revealed multiple cavitary lesions in the right upper lobe of 
      the lung, with a fungus ball and mucoid impaction. The eosinophil count, total 
      serum immunoglobulin E (IgE), and Aspergillus-specific IgE levels were elevated. 
      Specimens collected on bronchoscopy revealed fungal filaments compatible with 
      Aspergillus species. Based on these findings, a diagnosis of ABPA with 
      concomitant aspergilloma was made. Although treatment with corticosteroids and 
      antifungal agents was administered, the patient's respiratory symptoms persisted. 
      Therefore, he underwent lobectomy of the right upper lobe, which resulted in a 
      stable condition without the need for medication. Twenty-three months after 
      discontinuation of medical treatment, his respiratory symptoms gradually worsened 
      with a recurrence of elevated eosinophil count and total serum IgE. Imaging 
      revealed recurrent bronchiectasis and cavities with mucoid impaction in the right 
      lower lobe, suggesting relapse of aspergilloma and ABPA. Corticosteroids and 
      antifungal agents were re-administered; aspergilloma improved slightly over a 
      5-year period, and ABPA remained well controlled with low-dose prednisolone 
      (5 mg/day). CONCLUSIONS: We describe the long-term follow-up outcomes of a 
      patient with concomitant ABPA and aspergilloma, who underwent surgical resection 
      for aspergilloma. Physicians should carefully monitor patients with coexisting 
      ABPA and aspergilloma, as the condition may relapse after remission, even despite 
      surgical resection for aspergilloma. Additionally, surgical resection for 
      aspergilloma could result in resolution of ABPA.
FAU - Horiuchi, Kohei
AU  - Horiuchi K
AD  - Department of Pulmonary Medicine, Eiju General Hospital, 2-23-16 Higashi Ueno, 
      Taito-ku, Tokyo, 110-8645, Japan. kohei.horiuchi17@gmail.com.
FAU - Asakura, Takanori
AU  - Asakura T
AD  - Department of Pulmonary Medicine, Eiju General Hospital, 2-23-16 Higashi Ueno, 
      Taito-ku, Tokyo, 110-8645, Japan.
AD  - Division of Pulmonary Medicine, Department of Medicine, Keio University School of 
      Medicine, Tokyo, Japan.
AD  - Department of Mycobacteriology, National Institute of Infectious Diseases, Tokyo, 
      Japan.
FAU - Hasegawa, Naoki
AU  - Hasegawa N
AD  - Center for Infectious Diseases and Infection Control, Keio University School of 
      Medicine, Tokyo, Japan.
FAU - Saito, Fumitake
AU  - Saito F
AD  - Department of Pulmonary Medicine, Eiju General Hospital, 2-23-16 Higashi Ueno, 
      Taito-ku, Tokyo, 110-8645, Japan.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20181204
PL  - England
TA  - BMC Pulm Med
JT  - BMC pulmonary medicine
JID - 100968563
RN  - 0 (Antifungal Agents)
RN  - 0 (Glucocorticoids)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Antifungal Agents/*administration & dosage
MH  - *Aspergillosis, Allergic Bronchopulmonary/diagnosis/etiology/physiopathology
MH  - *Aspergillus/drug effects/isolation & purification
MH  - Bronchoscopy/methods
MH  - *Eosinophils
MH  - Glucocorticoids/*administration & dosage
MH  - Humans
MH  - Immunoglobulin E/*blood
MH  - Leukocyte Count/methods
MH  - *Lung/diagnostic imaging/microbiology
MH  - Male
MH  - Middle Aged
MH  - *Pneumonectomy/adverse effects/methods
MH  - *Postoperative Complications/diagnosis/physiopathology
MH  - Pulmonary Aspergillosis/diagnosis/physiopathology/surgery
MH  - Radiography, Thoracic/methods
MH  - Recurrence
MH  - Treatment Outcome
PMC - PMC6280523
OTO - NOTNLM
OT  - Allergic bronchopulmonary aspergillosis
OT  - Aspergillus
OT  - Pulmonary Aspergillus overlap syndrome
OT  - Relapse
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Not applicable. CONSENT FOR 
      PUBLICATION: Written informed consent was obtained from the patient for 
      publication of this case report. COMPETING INTERESTS: The authors declare that 
      they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains 
      neutral with regard to jurisdictional claims in published maps and institutional 
      affiliations.
EDAT- 2018/12/06 06:00
MHDA- 2019/04/04 06:00
PMCR- 2018/12/04
CRDT- 2018/12/06 06:00
PHST- 2018/09/12 00:00 [received]
PHST- 2018/11/19 00:00 [accepted]
PHST- 2018/12/06 06:00 [entrez]
PHST- 2018/12/06 06:00 [pubmed]
PHST- 2019/04/04 06:00 [medline]
PHST- 2018/12/04 00:00 [pmc-release]
AID - 10.1186/s12890-018-0743-0 [pii]
AID - 743 [pii]
AID - 10.1186/s12890-018-0743-0 [doi]
PST - epublish
SO  - BMC Pulm Med. 2018 Dec 4;18(1):185. doi: 10.1186/s12890-018-0743-0.