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Aspergillosis--clinical aspects.

P A Greenberger

    Zentralblatt Fur Bakteriologie, Mikrobiologie, Und Hygiene. Series A, Medical Microbiology, Infectious Diseases, Virology, Parasitology
    |July 1, 1986
    PubMed
    Summary
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    Cloning and expression of Aspergillus fumigatus allergen Asp f 16 mediating both humoral and cell-mediated immunity in allergic bronchopulmonary aspergillosis (ABPA).

    Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology·2001

    Allergic bronchopulmonary aspergillosis (ABPA) is a common lung disease often diagnosed late, presenting with varied symptoms and stages. Early detection and management are crucial for preventing severe lung damage.

    Area of Science:

    • Pulmonology
    • Allergy and Immunology
    • Medical Diagnostics

    Background:

    • Allergic bronchopulmonary aspergillosis (ABPA) is more prevalent than previously thought.
    • It can manifest in childhood and remain undiagnosed for years, potentially leading to end-stage lung disease.
    • Symptoms vary widely, from asymptomatic infiltrates detected by elevated IgE to severe asthma exacerbations.

    Purpose of the Study:

    • To highlight the prevalence and varied presentation of ABPA.
    • To describe diagnostic serologic assays for ABPA.
    • To outline the five distinct stages of ABPA disease activity.

    Main Methods:

    • Review of clinical, serologic, and radiologic features of ABPA.
    • Description of diagnostic criteria including total serum IgE, precipitins to Aspergillus fumigatus, and specific IgE/IgG.

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  • Identification and characterization of five disease stages: Acute, Remission, Recurrent Exacerbation, Corticosteroid-Dependent Asthma, and Fibrotic.

    • Main Results:

    • Diagnostic assays include elevated total IgE, Aspergillus fumigatus precipitins, and specific IgE/IgG.
    • Five stages of ABPA are defined: Acute (classic features), Remission (infiltrate resolution), Exacerbation (new infiltrate, elevated IgE), Corticosteroid-Dependent Asthma (wheezing upon steroid reduction), and Fibrotic (irreversible lung damage).
    • ABPA can present with diverse clinical and radiologic findings, sometimes without chronic symptoms.

    Conclusions:

    • ABPA is a significant condition with a broad clinical spectrum.
    • Accurate diagnosis relies on a combination of clinical presentation, serologic markers, and imaging.
    • Understanding the five stages aids in recognizing disease activity and guiding management to prevent progression to fibrotic lung disease.