Abstract
We report the case of a 12-year-old girl with an allergic bronchopulmonary aspergillosis (ABPA), intermediate sweat chloride tests and one cystic fibrosis (CF)-causing mutation, p.Phe508del. After extensive screening of the CF transmembrane regulator (CFTR) gene, she finally was found to carry a rare deep intronic mutation (c.872-1110_1113delGAAT), which confirmed the atypical mild CF disease. Although a classical steroid treatment did not allow the healing of the ABPA, an omalizumab therapy led to a long-term recovery. This case emphasises the need to search for rare CFTR gene mutations as far as possible when a CF disease is evocated. Moreover, it also highlights that although omalizumab is not yet recognised as a classical ABPA treatment in CF, it should be considered as an alternative therapy in steroid-resistant patients.
MeSH terms
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Anti-Allergic Agents / therapeutic use
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Antibodies, Anti-Idiotypic / therapeutic use
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Antibodies, Monoclonal, Humanized / therapeutic use
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Aspergillosis, Allergic Bronchopulmonary / diagnosis
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Aspergillosis, Allergic Bronchopulmonary / drug therapy
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Aspergillosis, Allergic Bronchopulmonary / etiology
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Aspergillosis, Allergic Bronchopulmonary / genetics*
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Child
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Cystic Fibrosis / complications
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Cystic Fibrosis / diagnosis
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Cystic Fibrosis / genetics*
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Cystic Fibrosis Transmembrane Conductance Regulator / genetics*
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Drug Resistance
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Female
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Genetic Testing
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Humans
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Introns*
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Mutation*
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Omalizumab
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Phenotype*
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Severity of Illness Index*
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Steroids / therapeutic use
Substances
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Anti-Allergic Agents
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Antibodies, Anti-Idiotypic
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Antibodies, Monoclonal, Humanized
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CFTR protein, human
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Steroids
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Cystic Fibrosis Transmembrane Conductance Regulator
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Omalizumab