Allergic bronchopulmonary aspergillosis

Allergic bronchopulmonary aspergillosis (ABPA) is an immunologic bronchopul monary inflammation due to an immune response of the lower respiratory trac t against Aspergillus fumigatus. The major clinical features of ABPA includ e asthma, recurrent pulmonary infiltrates, immediate wheal and flare skin r eactivity to A. fumigatus, elevated total serum IgE levels, detectable seru m precipitating antibodies to A. fumigatus, peripheral blood eosinophilia, elevated levels of Aspergillus-specific serum IgE and central bronchiectasi s with normal distal structures. The diagnosis of ABPA should be considered in asthmatics of all ages. Evolution of the disease comprises five stages from the acute to the fibrotic stage including pulmonary fibrosis and respi ratory insufficiency. The goals of ABPA treatment are to control patient's asthma and prevent exacerbations of ABPA. During the acute stage, prednison e should be administered. Antifungals agents (itraconazole) may be useful t o prevent exacerbations of the disease.