pulmonary disorders
Allergic Bronchopulmonary Aspergillosis (ABPA)
Treatment
Prednisone Sometimes antifungal drugs Treatment is based on disease stage (see table Stages of Allergic Bronchopulmonary Aspergillosis* ). Stage I is treated withprednisone0.5 to 0.75 mg/kg orally once a day for 2 to 4 weeks, then tapered over 4 to 6 months. Chest x-ray, blood eosinophil count, and IgE levels should be checked quarterly for improvement, defined as resolution of infiltrates,≥50% decline in eosinophils, and 33% decline in IgE. Patients who achieve stage II disease require annual monitoring only. Stage II patients who relapse (stage III) are given another trial ofprednisone. Stage I or III patients who do not improve withprednisone(stage IV) are candidates for antifungal treatment.Itraconazole200 mg orally twice a day for 16 weeks is recommended as a substitute forprednisoneand as a corticosteroid-sparing drug. Also, merging data address the use of biologic therapies such asomalizumabas steroid-sparing drugs. Symptoms and complications for stage V patients are usually treated supportively. Itraconazoletherapy requires checking drug levels and monitoring liver enzymes and triglyceride and potassium levels. All patients should be optimally treated for their underlying asthma or cystic fibrosis. In addition, patients taking long-term corticosteroids should be monitored for complications, such as Cataract , 