Aspergillosis and prednisone

[kimmy60]

I was diagnosed with Allergic bronciopulminary aspergilosis in October of last year. What was thought to be a routine asthma exarbation I was hospitalized. I did not respond to treatment in a matter of days and I felt something differant was the cause. I was not coughing or bringing up any mucus but when I did bring something up it was blood. My Ige level was tested and came back at 3000+. I then had a CT Scan done and was diagnosed with ABPA, although aspergilosis anti bodies testing in my blood came back negitive.
I have been on steroids for 10 monthes and have steroid induced Cushings syndrome. I am down to an Ige level of 300, and a dosage of 20 mg of prednisone daily.
The Cushings has completly destoyed me I cannot work. I can bearly walk, or move cognitive disfuntion etc.
What started as an asthme attack has turned into a life altering condition. Does ABPA ever go away? Has the stroids destroyed my adrenal glands? Could I have been misdiagnosed?
I have lost everything to this disease my job my house my health everything.
Has anyone experienced the terrible effects of prednisone?
Thank you

[National Jewish Health]

Allergic bronchopulmonary aspergillosis (ABPA) can result in significant impairment of lung function.  Conventional therapy with high dose systemic corticosteroids remains the standard, very often in combination with the antifungal agent itraconazole.

We deeply sympathize with the severe steroid side effects you have experienced.  The side effects of steroid therapy can be as bad as the disease.  Steroid side effects can also include metabolic abnormalities and, for this reason, attempts have been made to eradicate Aspergillus from the airways using itraconazole as a steroid-sparing agent.  You should ask your doctors about the addition of itraconazole to your steroid therapy, if that has not already been given.

There is at least 1 case report of the successful treatment of a person with cystic fibrosis (CF) and ABPA with the anti-IgE antibody omalizumab.  You might want to ask your pulmonologist if he/she has knowledge of more recent/ongoing trials of this medicine and if this might be an option, given the severity of your situation.

Needless to say, your prednisone therapy should be tapered as rapidly as the ABPA will allow, with careful monitoring of the serum IgE and other ABPA variables.

Good luck.

[herdingcats]

A related discussion, Steroids and lung problems was started.