Hypersensitivity reaction to Aspergillus fumigatus mould that has colonised bronchi of patients with asthma or cystic fibrosis.
Exposure of atopic people to fungal spore elements results in the formation of IgE and IgG antibodies.
Presents as asthma complicated by bronchial obstruction, fever, malaise, expectoration of brownish mucus plugs, peripheral blood eosinophilia, and haemoptysis.
Treatment involves environmental control measures, corticosteroids, and itraconazole.
Early detection and treatment can prevent the development of bronchiectasis or pulmonary fibrosis that otherwise occurs in the later stages of the disease.
Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to mould that occurs when bronchi become colonised by Aspergillus fumigatus in an otherwise immunocompetent person. Patients usually have a prior diagnosis of atopy, asthma, or cystic fibrosis. Exposure of an atopic person to fungal elements results in the formation of IgE and IgG antibodies. Typically, the patient presents with bronchial obstruction, airway inflammation, and mucoid impaction that can lead to bronchiectasis, fibrosis, and respiratory compromise.
History and exam
Department of Pulmonary, Allergy and Critical Care
CR is on the Advisory Boards for CSL Behring and Shire (advising on treatments for hereditary angio-oedema).
Department of Pediatrics
University of Bern
MS declares that he has no competing interests.
Professor of Pediatrics
Medical College of Wisconsin
JF is an author of a number of references cited in this monograph.
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