We describe the case of a 43-year-old woman with allergic bronchopulmonary mycosis (ABPM) and severe asthma who improved clinically on mepolizumab with eosinophil suppression but had recurrent mucus plugs, persistent right-middle-lobe atelectasis, rising fractional exhaled nitric oxide (FeNO), and high total IgE levels. Here, IGHE is linked to allergic bronchopulmonary aspergillosis.