MANAGEMENT OF ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS WITHOUT MAINTENANCE ORAL CORTICOSTEROIDS - A 15-YEAR FOLLOW-UP

Five non-smoking patients were diagnosed as having allergic bronchopul monary aspergillosis in 1978/9. All have been treated since then with inhaled corticosteroids, using short courses of self-administered oral corticosteroids for symptomatic exacerbations. Over a mean 15 years o f follow-up, they have required on average less than one course of ora l drugs per annum. Regular monitoring of spirometry has shown no evide nce of deterioration, and all have close to normal gas transfer. All h ave some localized bronchiectasis on CT scanning, in two cases probabl y occuring after treatment started, but in no case is there any respir atory disability. We conclude that this is a safe and effective method for the management of allergic bronchopulmonary aspergillosis when di agnosed before persistent hyphal colonization of the airways has occur red.