Revista chilena de pediatría
versión impresa ISSN 0370-4106
MAGGIOLO M, Julio et al. Allergic Bronchopulmonary Aspergillosis in Children with Chronic Lung Disease and Cystic Fibrosis. Rev. chil. pediatr. [online]. 2006, vol.77, n.2, pp. 161-168. ISSN 0370-4106. http://dx.doi.org/10.4067/S0370-41062006000200006.
Background: Allergic bronchopulmonary aspergillosis (ABPA) is rare in children, however, it is necessary to make an early diagnosis in order to establish the adequate therapy to avoid pulmonary damage. Objective: To present our experience in the management of ABPA in children with chronic lung disease and cystic fibrosis. Patients and Methods: 6 patients during 2000-2003 were recluted, 4 males, mean age 13 years (range 9 to 17 years). ABPA study was done in children with chronic lung disease or cystic fibrosis with clinical manifestations, and diagnosis was made when two or more positive cultures for Aspergillus sp. with hyphaes, and one or more primary criteria were found. Results: All the patients showed specific IgG, 5/6 had positive skin test and eosinophilia, 6/6 developed new interstitial infiltrates and 2 patients had central bronchiectasis. The patients received treatment with Prednisone 2 mg/k daily for one month followed by Prednisone 2 mg/k every other day for 4 months, plus Itraconazol 2-5 mg/k/day for 5 months. After the treatment, all the children experiment clinical and PEF improvement (also 4/6 had better spirometric values), 6/6 less pulmonary infiltrates and the cultures and specific IgG became negative. There were no important secondary effects. Conclusion: ABPA in children is rare, however it produces pulmonary damage, so it must be considered in patients with bronchial asthma, chronic lung disease or cystic fibrosis. The treatment proposed was successful
Palabras clave : allergic bronchopulmonary aspergillosis; chronic lung disease; cystic fibrosis; Aspergillus; hyphaes.