Allergic bronchopulmonary aspergillosis: a study of 46 cases with special reference to laboratory aspects

A study of 46 cases of allergic bronchopulmonary aspergillosis has been presented with special reference to laboratory aspects. Episodic airways obstruction and dual skin reaction to aspergillin were present in all the cases. Furthermore, there were pulmonary infiltrations in 91.1%, blood eosinophilia in 80.4%, precipitins in 91.3%, and sputum cultures repeatedly positive for A. fumigatus in 82.6% of the patients. It was observed that the multiplicity of precipitin bands corresponded to the higher recovery of A. fumigatus in culture. A. flavus and A. niger were recovered from 58.7 and 80.4% cases of allergic bronchopulmonary aspergillosis respectively but dual skin reactions to these species occurred only in 47.6 and 26.2% and precipitins in 21.7 and 4.3% of cases, respectively. The findings are compatible with the poor allergenic and antigenic properties attributed to these two species in comparison with A. fumigatus. It is suggested that allergic bronchopulmonary aspergillosis may not be too uncommon in India and it deserves greater attention in the differential diagnosis of chest diseases.