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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
"glucocorticoid-dependent disease"
symptom
allergic bronchopulmonary aspergillosis
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