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Atypical Presentation of Allergic Bronchopulmonary Aspergillosis: An Unusual Cause of Difficult-to-Treat Asthma.
[allergic bronchopulmonary aspergillosis]
Allergic
Bronchopulmonary
aspergillosis
(
ABPA
)
commonly
presents
with
persistently
uncontrolled
asthma
,
despite
of
the
therapy
with
highest
possible
anti-
asthma
medications
.
Most
common
cause
of
ABPA
is
Aspergillus
fumigates
.
Hence
,
ABPA
is
one
of
the
important
differential
diagnoses
of
difficult-
to
-treat
asthma
.
Atypical
presentation
of
ABPA
misleads
the
diagnosis
and
asthma
remains
uncontrolled
.
Here
we
present
such
a
case
of
28
-
year
-old
non-smoker
,
normotensive
male
office
worker
who
presented
with
persistent
cough
with
scanty
white
,
mucoid
expectoration
and
gradually
progressive
breathlessness
with
bilateral
crackles
for
last
two
years
.
Diagnosis
of
asthma
was
made
based
on
clinical
evidences
and
spirometry
.
Anti-
asthma
treatment
was
started
and
gradually
stepped
up
.
Further
evaluation
was
done
due
to
lack
of
clinical
improvement
,
and
diagnosis
of
ABPA
was
made
from
bilateral
reticulonodular
lesions
on
HRCT
thorax
,
increased
levels
of
serum
IgE
and
Aspergillus
fumigates
specific
IgE
,
and
positive
aspergillin
skin
test
.
Oral
prednisolone
and
itraconazole
were
started
with
anti-
asthma
medications
.
Diseases
Validation
Diseases presenting
"common cause"
symptom
achondroplasia
acute rheumatic fever
adrenomyeloneuropathy
allergic bronchopulmonary aspergillosis
alpha-thalassemia
aniridia
aromatase deficiency
benign recurrent intrahepatic cholestasis
cadasil
child syndrome
coats disease
congenital adrenal hyperplasia
congenital toxoplasmosis
cushing syndrome
erdheim-chester disease
esophageal adenocarcinoma
esophageal squamous cell carcinoma
fabry disease
familial hypocalciuric hypercalcemia
hydrocephalus with stenosis of the aqueduct of sylvius
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
lamellar ichthyosis
legionellosis
liposarcoma
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
pendred syndrome
primary hyperoxaluria type 1
pyruvate dehydrogenase deficiency
scrub typhus
systemic capillary leak syndrome
thoracic outlet syndrome
typhoid
von hippel-lindau disease
wiskott-aldrich syndrome
zellweger syndrome
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