Allergic Bronchopulmonary Aspergillosis – need for routine screening of all patients with asthma with an Aspergillus skin test

Ritesh Agarwal, MD, DM, FCCP
 
From the Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
 
Abstract
 
Allergic bronchopulmonary aspergillosis (ABPA) is an immunologic pulmonary disorder caused by hypersensitivity to Aspergillus fumigatus. Clinically, a patient presents with chronic asthma, recurrent pulmonary infiltrates, and bronchiectasis. The population prevalence of ABPA is not clearly known, but the prevalence in asthma clinics is reported to be around 13%. The disorder needs to be detected before bronchiectasis has developed because the occurrence of bronchiectasis is associated with poorer outcomes. Because many patients with ABPA may be minimally symptomatic or asymptomatic, a high index of suspicion for ABPA should be maintained while managing any patient with bronchial asthma whatever the severity or the level of control. This underscores the need for routine screening of all patients with asthma with an Aspergillus skin test. Finally, there is a need to update and revise the criteria for the diagnosis of ABPA. This review summarizes the advances in the diagnosis and management of ABPA using a systematic search methodology.
 
Keywords:
  • allergic bronchopulmonary aspergillosis
  • Aspergillus
  • bronchial asthma
  • cystic fibrosis
  • prevalence

     
    chestjournal.org

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