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Allergic bronchopulmonary aspergillosis in asthma: epidemiological, clinical and therapeutic issues.
[allergic bronchopulmonary aspergillosis]
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
.
Diseases
Validation
Diseases presenting
"early diagnosis"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
alexander disease
allergic bronchopulmonary aspergillosis
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
classical phenylketonuria
coats disease
cohen syndrome
congenital adrenal hyperplasia
congenital diaphragmatic hernia
congenital toxoplasmosis
cowden syndrome
cushing syndrome
cutaneous mastocytosis
cystinuria
dentin dysplasia
dentinogenesis imperfecta
dracunculiasis
erdheim-chester disease
erythropoietic protoporphyria
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
hirschsprung disease
holt-oram syndrome
homocystinuria without methylmalonic aciduria
hydrocephalus with stenosis of the aqueduct of sylvius
inclusion body myositis
kabuki syndrome
kallmann syndrome
kindler syndrome
krabbe disease
locked-in syndrome
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
omenn syndrome
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
primary effusion lymphoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
triple a syndrome
typhoid
von hippel-lindau disease
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
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