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Abstract
Allergic bronchopulmonary aspergillosis (ABPA) is a complex pulmonary disorder caused by immunologic reactions to antigens released by Aspergillus fumigatus, a ubiquitous fungi colonizing the tracheobronchial tree of asthmatic patients. The clinical presentation is usually poorly controlled asthma, recurrent pulmonary opacities and bronchiectasis. The prevalence of ABPA in asthma clinics may be as high as 13% with a global burden of almost 5 million patients. A. fumigatus-specific IgE level is the most sensitive test in diagnosis of ABPA, and all asthmatic patients should be routinely screened with A. fumigatus-specific IgE levels for early diagnosis. The goals of managing ABPA include control of asthma, prevention and treatment of acute exacerbations, and preventing the development or progression of bronchiectasis. Glucocorticoids are the treatment of choice with itraconazole reserved for those with recurrent exacerbations and glucocorticoid-dependent disease. There is a dire need for newer treatment approaches including oral antifungal agents and immunomodulatory therapy.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
Notes
† If the patient meets all other criteria, an IgE value <1000 IU/ml may be acceptable.
‡Chest radiographic features may be either transient (i.e., consolidation, nodules, tram-track opacities, toothpaste/finger-in-glove opacities and fleeting opacities) or permanent (i.e., parallel line and ring shadows, bronchiectasis and pleuropulmonary fibrosis).
ABPA: Allergic bronchopulmonary aspergillosis.
Reproduced with permission from Citation[12].
ABPA: Allergic bronchopulmonary aspergillosis.
Reproduced with permission from Citation[12].
ABPA: Allergic bronchopulmonary aspergillosis.
Data taken from Citation[2,3,12].