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Allergic bronchopulmonary aspergillosis

Sonia N Bains1, Marc A Judson

  • 1Division of Pulmonary, Critical Care, Allergy & Sleep Medicine, Medical University of South Carolina, Charleston, 29425, USA.

Clinics in Chest Medicine
|May 30, 2012
PubMed

Insights

Allergic bronchopulmonary aspergillosis (ABPA) stems from an immune overreaction to Aspergillus fumigatus mold. Differentiating ABPA from asthma and cystic fibrosis is key for effective diagnosis and management.

Area of Science:

  • Immunology
  • Pulmonology
  • Infectious Diseases

Background:

  • Allergic bronchopulmonary aspergillosis (ABPA) is an immune-mediated lung disease.
  • It results from an exaggerated T helper 2 (TH2) response to Aspergillus fumigatus.
  • ABPA occurs in a small subset of patients with asthma and cystic fibrosis, indicating host susceptibility factors.

Purpose of the Study:

  • To review the immunopathology of ABPA.
  • To outline clinical and laboratory findings for ABPA diagnosis.
  • To present a diagnostic algorithm and management strategy for ABPA.

Main Methods:

  • Literature review of current understanding of ABPA.
  • Analysis of clinical and laboratory features differentiating ABPA from asthma and cystic fibrosis.
  • Development of a practical diagnostic and management algorithm.

Main Results:

  • ABPA is characterized by an exaggerated TH2 response to Aspergillus fumigatus.
  • Clinical and serologic similarities between ABPA, asthma, and cystic fibrosis pose diagnostic challenges.
  • A clear diagnostic algorithm and management plan are needed.

Conclusions:

  • Host defects are crucial in ABPA susceptibility.
  • Distinguishing ABPA from asthma and cystic fibrosis requires careful evaluation of clinical and laboratory data.
  • A structured approach aids in the diagnosis and treatment of ABPA.

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