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ABPA Concomitantly Occurring with Invasive Sinus Aspergillosis: A Short Report on Two Patients.
[allergic bronchopulmonary aspergillosis]
Allergic
bronchopulmonary
aspergillosis
(
ABPA
)
is
a
pulmonary
disorder
that
is
caused
by
hypersensitivity
to
Aspergillus
fumigatus
with
resultant
systemic
immune
activation
,
chronic
asthma
,
recurrent
pulmonary
infiltrates
,
and
bronchiectasis
.
First
described
by
Hinson
et
al
.
(
Thorax
7
:
317
-
333
[
1
]
)
in
1952
,
this
disease
occurs
in
1
-
2
%
of
patients
with
persistent
asthma
and
in
2
-
15
%
of
patients
with
cystic
fibrosis
(
Greenberger
,
Front
Biosci
8
:
s
119
-
s
127
[
2
]
)
.
Although
the
diagnostic
criteria
for
ABPA
have
been
laid
down
(
and
include
bronchial
asthma
,
immediate
skin
test
reactivity
to
A
.
fumigatus
,
elevated
total
serum
IgE
level
,
pulmonary
infiltrates
,
central
bronchiectasis
,
peripheral
blood
eosinophilia
,
and
positive
serum
precipitins
[
IgG
]
against
Aspergillus
antigen
)
,
none
of
these
are
specific
for
ABPA
(
Shah
,
Curr
Opin
Pulm
Med
13
(
1
)
:
72
-
80
[
3
]
)
.
There
is
still
no
consensus
on
the
number
of
criteria
needed
for
diagnosis
,
and
patients
in
different
stages
of
ABPA
may
not
fulfill
all
these
criteria
(
Greenberger
,
Front
Biosci
8
:
s
119
-
s
127
[
2
]
;
Chakrabarti
et
al
.
,
Mycoses
45
:
295
-
299
[
4
]
)
.
An
high
-resolution
CT
(
HRCT
)
scan
showing
central
bronchiectasis
and
high
attenuation
mucus
is
presently
the
investigation
of
choice
for
the
diagnosis
of
bronchiectasis
in
patients
with
ABPA
(
Shah
,
Front
Biosci
8
:
e
138
-
e
146
[
5
]
)
.
ABPA
has
also
been
reported
in
association
with
allergic
fungal
rhinosinusitis
in
English
literature
(
Shah
,
Curr
Opin
Pulm
Med
13
(
1
)
:
72
-
80
[
3
]
)
.
We
are
reporting
two
patients
with
invasive
aspergillosis
of
the
nose
,
paranasal
sinuses
and
orbit
,
who
were
diagnose
and
managed
successfully
for
ABPA
,
a
previously
unreported
entity
.
Diseases
Validation
Diseases presenting
"persistent asthma"
symptom
allergic bronchopulmonary aspergillosis
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