Allergic bronchopulmonary aspergillosis in children.

Allergic bronchopulmonary aspergillosis (ABPA) associates the development o f aspergillus in bronchus and a predominant immediate hypersensitivity for aspergillar antigens. It complicates an old and severe allergic asthma or c ystic fibrosis. Its prevalence is not well known. In children, ABPA prevale nce is rare, except in cystic fibrosis where 0.6% to 11% of patients can be affected by the disease. Acute exacerbation of the disease favours the dev elopment of bronchectasis and fibrosis. The diagnosis is suggested by an unexplained aggravation of asthma or, in c ystic fibrosis, by wheezing, an unsuccessful antibiotherapy, and a recent m odification of th(! chest X-ray. The diagnosis is based upon the presence o f seven major criteria or six major criteria and one minor The follow-up of biological parameters is important for early diagnosis of exacerbations. S ome parameters are very sensitive, ie, precipitins and total serum IgE. Systemic corticotherapy is the usual treatment of exacerbation The associat ion with inhaled corticotherapy could reduce the duration of systemic treat ment. The use of Itraconazol is logical, mainly in cystic fibrosis. (C) 199 9 Elsevier, Paris.