2-沈茜-20120707变应性支气管肺曲菌病.pptVIP

变应性支气管肺曲霉病——诊治实践;变应性支气管肺曲霉病(allergic bronchopulmonaryaspergilosis，ABPA);Because many patients with ABPA may be minimally symptomatic or asymptomatic, a high index of suspicion for ABPA should be maintained while managing any patient with bronchial asthma whatever the severity or the level of control.;典 型 病 例;病例（一）;现病史;现病史;过去史;入院诊断：;实验室检查;;纤支镜检查（2008.08.21）;诊断;住院期间：伊曲康唑，甲强龙治疗 患者一周后出现肝功能异常，停用伊曲康唑 出院带药：强的松片 10mg tid 2008.10.07 血嗜酸性粒细胞正常 IgE＞2000ku/l 胸部CT ;2008.10.07;病例（二）;;2009.04.03;2008.01.04;2008.01.08;初步诊断;入院后检查;;临床诊断：ABPA;04.10 04.27;;;2009.05.27;病例（三）;;11.01;11.18;11.25;外院辅助检查;入院后检查;临床诊断：ABPA;01.06;??例（四）;01.13;01.20;01.31;02.09;;;临床诊断：ABPA;;11.03.31;病例（五）;;4.12;;临床诊断：ABPA;;5.12;病例（六）;12.23;外院辅助检查;;思考1;ABPA诊断流程图;;思考2;思考3;;Successful treatment of allergic bronchopulmonary aspergillosis with recombinant anti-IgE antibody. Allergic bronchopulmonary aspergillosis (ABPA) can cause severe worsening of the respiratory condition in patients with cystic fibrosis. Treatment can result in steroid dependency and serious adverse events. A dramatic and rapid improvement of respiratory symptoms and lung function after a single dose of anti-IgE antibody (omalizumab) in a 12-year-old girl with cystic fibrosis and ABPA is described. This is the first report of this experimental treatment. It suggests an important role for IgE in the pathogenesis of ABPA and offers new therapeutic possibilities ;;;小 结;夏日风起 荷香沁人