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How do I treat : allergic bronchopulmonary aspergillosis in patients with cystic fibrosis
Thimmesch M , Pirson J , Bauwens N , Boboli H , Palem A
Rev Med Liege 2026, 81(01),11-16Abstract : Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus fumigatus, commonly found in patients with cystic fibrosis and severe asthma. It leads to bronchial inflammation, excessive mucus secretion, and progressive lung function decline. The diagnosis is challenging and is based on clinical, biological, and radiological criteria. Treatments include systemic corticosteroids, antifungals, and monoclonal antibodies such as omalizumab and mepolizumab. The triple combination of elexacaftor, tezacaftor, and ivacaftor indirectly improves ABPA by reducing inflammation and enhancing bronchial drainage. After presenting a complex clinical case, this article provides a synthesis of the diagnostic criteria for ABPA, and the different treatments.
