Allergic bronchopulmonary aspergillosis

It is a disease that develops with hypersensitivity to aspergillus antigens. Mainly A. fumigatus. It usually occurs in people with asthma, cystic fibrosis. It is also higher in people with atopy. náhled|Lung preparation with aspergillosis.

Klinický obraz
In ABPA, the lungs show reversible  'obstructive changes' , which, however, may progress to irreversible changes at more advanced stages. Restrictive lung disease develops with reduced diffusion disorders. Diffusion capacity of the lungs / Repetitorium | diffusion capacity]] due to airway suppression by mucus and hyphae and  ' central bronchiectasis'  (CB)

ABPA is divided into five stages:
 *  'acute'  - initial phase characterized by  ' asthma' , elevated IgE levels,  'eosinophilia' , pulmonary  'infiltrates'  and  'IgG'  and  'IgE'  antibodies against  A. fumigatus ,
 *  'remission phase'  - symptoms weakened (reduced),
 *  'exacerbation'  - rediscovery of initial symptoms, IgE level rises to  'twice' ,
 * phase occurring in patients with asthma dependent on regular use of  ' corticosteroids'  - asthma worsens, causing  'bronchiectasis' ,
 *  'fibrotic phase'  - development of  ' fibrosis'  in the upper lobes of the lungs.

Symptomatics
Patients exhibit  'episodic wheezing' ,  'coughing up sputum'  with brown  'coatings ','  chest pain  'and'  fever  '.

Diagnostics
Diagnostic criteria for ABPA are  'asthma' , immediate  'skin reaction'  to Aspergillus, presence of  'IgG'  and  ' IgE  'against' 'A. fumigatus' 'in the blood, IgE level higher than'  1000 IU / ml  ', occurrence of pulmonary'  infiltrates'  on CT chest, eosinophilia (1000 cells / µl).

Treatment
Most cases require treatment with systemic corticosteroids.  ' Corticosteroids'  (suppression of hypersensitivity and inflammatory responses). The drug of choice is mainly  'prednisone' . In some cases, "itraconazole" is also used.

Related articles

 * Aspergillosis
 * Invasive aspergillosis
 * CNPA
 * Aspergiloma
 * Invasive fungal infections
 * Aspergil infections