Allergic Bronchopulmonary Aspergillosis (Abpa)

Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus species (usually A. fumigatus), almost exclusively in patients with asthma or, more rarely, cystic fibrosis occurs. The immune response to Aspergillus antigens cause airway obstruction and untreated, leads to bronchiectasis and pulmonary fibrosis. The symptoms are the same as in asthma, in addition cough and sometimes fever and cachexia can occur more productive. The diagnosis is suspected on the basis of medical history and imaging method and confirmed by an Aspergillus -Hauttest, measurement of IgE, circulating precipitins and A. fumigatus specific antibodies. Treatment is with corticosteroids and in refractory forms with itraconazole.

ABPA occurs when the airways of asthmatics or patients with cystic fibrosis with the Aspergillus sp. (Ubiquitous soil fungus) are populated.

Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus species (usually A. fumigatus), almost exclusively in patients with asthma or, more rarely, cystic fibrosis occurs. The immune response to Aspergillus antigens cause airway obstruction and untreated, leads to bronchiectasis and pulmonary fibrosis. The symptoms are the same as in asthma, in addition cough and sometimes fever and cachexia can occur more productive. The diagnosis is suspected on the basis of medical history and imaging method and confirmed by an Aspergillus -Hauttest, measurement of IgE, circulating precipitins and A. fumigatus specific antibodies. Treatment is with corticosteroids and in refractory forms with itraconazole. ABPA occurs when the airways of asthmatics or patients with cystic fibrosis with the Aspergillus sp. (Ubiquitous soil fungus) are populated. Pathophysiology unknown reasons leading the colonization in these patients to pronounced antibody (IgE and IgG) mediated and cellular immune responses (type I, III and IV hypersensitivity reaction) to Aspergillus antigens, triggering frequent, recurrent asthma attacks. Over time, the immune responses, in conjunction with direct toxic effects of the fungus to the destruction and enlargement of the respiratory tract that result in bronchiectasis and fibrosis. Histologic hallmark of the disease are of secretion in the airways, eosinophilic inflammation, infiltration of alveolar septa with plasma and mononuclear cells, and a proliferation of bronchial mucous glands and goblet cells. Rarely can one other fungi such. As Penicillium, Candida, Curvularia, Helminthosporium and Drechslera spp. cause the same disease, which is then referred to as allergic bronchopulmonary mycosis in the absence of an underlying asthma or cystic fibrosis. Aspergillus is intraluminal present but growing non-invasive. Thus ABPA must be distinguished from those found in immunocompromised patients invasive aspergillosis, such as the aspergilloma, which corresponds to an accumulation of Aspergillus in patients with pre-formed cavernous lesions or cystic lung cavities and the rare Aspergillus conjunctivitis and pneumonia that may occur in patients with low-dose Prednisondauertherapie (z. B. COPD). Although the distinction may be clear overlap syndromes have occurred. Symptoms and signs The symptoms are the same as in asthma or exacerbation of cystic fibrosis with an additionally existing productive cough with dirty green or brown sputum and occasionally hemoptysis. Fever, headache and cachexia are common systemic symptoms of serious illness. The findings are the same as airway obstruction (esp. Wheezing and prolonged exhalation) and can not be distinguished from asthma attacks. Diagnosis history of asthma chest X-ray or high-resolution CT skin prick test with Aspergillus antigen Aspergillus precipitins in the blood Positive sputum culture for Aspergillus species (or, rarely, other fungi) IgE levels The diagnosis is suspected in asthma patients in whom recurrent asthma attacks, wandering or non-dissolving infiltrates on chest x-ray (often caused by atelectasis by of secretion and bronchial obstruction), radiologically proven bronchiectasis (bronchiectasis: diagnostic) on A. fumigatus- positive sputum or peripheral eosinophilia are present. Allergic bronchopulmonary aspergillosis with permission of the publisher. From resentment A. Walsh T. In Atlas of Infectious Diseases: Fungal Infections. Edited by G. L. Mandell and R.D. Diamond. Philadelphia, Current Medicine, 2000. var model = {thumbnailUrl: ‘/-/media/manual/professional/images/allergic_bronchopulmonary_aspergillosis_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/ – / media / manual / professional / ? images / allergic_bronchopulmonary_aspergillosis_high_de.jpg lang = en & thn = 0 ‘, title:’ allergic bronchopulmonary aspergillosis ‘description:’ u003Ca id = “v38395395 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eDas postero-anterior chest x-ray showing “”glove”” shaped shade (arrows)

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