Open AccessAllergic bronchopulmonary aspergillosis in a patient with ankylosing spondylitis treated with adalimumab
Author(s) -
Suzuki Yudai,
Takasaka Naoki,
Matsubayashi Sachi,
Kojima Ayako,
Shinfuku Kyota,
Hasegawa Tsukasa,
Yamada Masami,
Fujisaki Ikumi,
Seki Aya,
Seki Yoshitaka,
Ishikawa Takeo,
Kuwano Kazuyoshi
Publication year - 2021
Publication title -
respirology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 9
ISSN - 2051-3380
DOI - 10.1002/rcr2.805
Subject(s) - medicine , adalimumab , ankylosing spondylitis , bronchiectasis , aspergillus fumigatus , allergic bronchopulmonary aspergillosis , itraconazole , immunology , sputum culture , aspergillosis , sputum , prednisolone , dermatology , immunoglobulin e , antibody , gastroenterology , pathology , lung , tumor necrosis factor alpha , tuberculosis , antifungal
We herein report a case of allergic bronchopulmonary aspergillosis (ABPA) that occurred in a man treated with adalimumab for ankylosing spondylitis (AS). A 69‐year‐old man with a history of ankylosing spondylitis treated by adalimumab, an anti‐tumour necrosis factor‐α (TNF‐α) antibody, developed cough and wheezing. Chest computed tomography showed obstruction of dilated left upper lobe bronchus by high attenuation mucus as well as central bronchiectasis. Both Aspergillus ‐specific immunoglobulin E (IgE) and Aspergillus precipitating antibody were positive and Aspergillus fumigatus was detected in a sputum culture. According to the new diagnostic criteria, the patient was diagnosed with ABPA. His condition rapidly improved after the withdrawal of adalimumab and initiation of prednisolone and itraconazole. Anti‐TNF‐α antibody might cause ABPA through both aggravation of the host's T‐helper 2 immunological response and anti‐fungal response.