Allergic bronchopulmonary aspergillosis

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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[edit | edit source]

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[edit | edit source]

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

Diagnostics[edit | edit source]

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[edit | edit source]

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.


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Kategorie:Vložené články Kategorie:Pneumologie Kategorie:Mikrobiologie Kategorie:Imunologie Kategorie:Infekční lékařství