Two different diseases in two adolescent girls with the same clinic: Allergic bronchopulmonary aspergillosis

Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity reaction observed in asthma as well as cystic fibrosis (CF) patients due to the colonization of the airways by Aspergillus fumigatus. While ABPA is most commonly observed in CF patients (2-9%), it is seen at a rate of 1-2% in patients diagnosed with asthma. ABPA is mostly seen in steroid dependent adult asthma patients and has rarely been reported in pediatric asthma patients. The aim of our study was to provide the clinical, laboratory, and radiological characteristics of two patients under our follow-up care who were also diagnosed with ABPA. In the pediatric population, ABPA is often seen in patients with cystic fibrosis and rarely as a complication of childhood asthma. However, it is not clear whether this is because ABPA is really rare or because there is low level of suspicion for this disease. Furthermore, diagnostic criteria and staging systems are created by taking adults into consideration and not having different diagnostic criteria or staging systems for pediatric patients makes the diagnosis even more difficult.