Complexity of differential diagnosis of allergic bronchopulmonary aspergillosis and severe bronchial asthma in a time of mepolizumab use
Abstract. Allergic bronchopulmonary aspergillosis (ABPA) is a chronic infectious-allergic disease of the respiratory system caused by fungi of the family Aspergillus and taking clinical course as progressive bronchial asthma (BA). When examining patients suffering from chronic polypous rhinosinusitis (CPRS) with comorbid asthma and peripheral eosinophilia, it is necessary to exclude ABPA. Current article demonstrates the complexity of differential diagnosis of ABPA and severe asthma in female patient with CPRS and intolerance to nonsteroidal anti-inflammatory drugs receiving mepolizumab. It is necessary to make a screening examination for ABPA in patients with Th2 cell inflammation who have a combination of asthma, CPRS and peripheral eosinophilia, as a risk group for bronchopulmonary aspergillosis development. Such an examination is especially relevant among candidates for genetically engineered biological therapy, since the detection of ABPA will require correction or a radical change in their therapy.Dementyeva M.A., Gumilevskaya O.P., Gumilevsky B.Yu.
Keywords
allergic pulmonary aspergillosis
bronchial asthma
chronic polypous rhinosinusitis
Th2 cell inflammation
biological therapy
mepolizumab
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About the Authors
Maria A. Dementyeva, MD, otolaryngologist at Saint Petersburg Medical and Social Institute. Address: 195271, Saint Petersburg, 72A Kondratyevsky Avenue.E-mail: mary.filippova@yandex.ru
ORCID: https://orcid.org/0009-0009-4835-0636
Oksana P. Gumilevskaya, MD, Dr. Sci. (Medicine), associate professor of the Department of infectology, Saint Petersburg Medical and Social Institute. Address: 195271, Saint Petersburg, 72A Kondratyevsky Avenue.
E-mail: ogum@mail.ru
ORCID: https://orcid.org/0000-0001-9852-9372
Boris Yu. Gumilevsky, MD, Dr. Sci. (Medicine), professor, head of the Department of microbiology, S.M. Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation. Address: 194044, Saint Petersburg, 6 Academika Lebedeva St.
E-mail: vmeda-na@mil.ru
ORCID: https://orcid.org/0000-0001-8755-2219
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