Diagnosis and Management of Allergic Bronchopulmonary Aspergillosis
Abstract:Early diagnosis and treatment is essential for patients afflicted with bronchopulmonary aspergillosis (ABPA). Inflammatory damage to the airways may be significantly reduced through use of corticosteroids. Without treatment, bronchiectasis causing permanent anatomic alteration of the airways may occur. ABPA should be considered in any asthmatic who requires oral corticosteroids and has recurrent pulmonary infiltrates. Evaluation should include determination of total serum IgE, which generally exceeds 1000 ng/mL in patients with ABPA. Disease categorization of ABPA patients may be made according to radiographic and clinical considerations into jive stages. The treatment choice for ABPA is prednisone, although inhaled corticosteroids including beclomethasone dipropionate may also be used in long-term asthma management. Successful therapy of ABPA is typically associated with a decline in total serum IgE, subsequent exacerbations often being associated with elevation in total serum IgE. Allergen avoidance is essential for the ABPA patient, as exposure to heavy concentrations of fungi may precipitate disease exacerbation.
Document Type: Research Article
Publication date: 1994-11-01
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- Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.
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