Allergic bronchopulmonary aspergillosis (ABPA) an IgE mediated disease?

This case is about a 6-year-old boy with cystic fibrosis (CF), suffering from allergic bronchopulmonary aspergillosis (ABPA) with total atelectasis of the left lung. To prove the hypothesis that IgE mediated disease is the major pathomechanism of ABPA, a bronchial provocation with Aspergillus fumigatus was performed before and after treatment with omalizumab (OMA). We could demonstrate for the first time that OMA completely suppresses the early allergic reaction (EAR) after bronchial allergen challenge with Aspergillus. Moreover, as has been shown by others, our patient showed a marked improvement of FEV₁ without a relapse after tapering systemic steroid treatment.