Allergic aspergillosis: review of 32 cases

Henderson, A. H.

doi:10.1136/thx.23.5.501

Cited by 137 publications

(50 citation statements)

References 22 publications

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“…CAMPBELL and CLAYTON [8] reported 87 cases, FRANKLAND and DAVIS [9] 36 cases, HENDERSON [10] 32 cases, SIMON [11] 111 cases and EDGE et al [12] 12 cases, all in the UK. In the USA, this disorder was thought to be rare.…”

Section: Allergic Bronchopulmonary Aspergillosismentioning

confidence: 99%

Many faces of pulmonary aspergillosis

Sharma

Chwogule²

1998

Eur Respir J

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Aspergillus is a ubiquitous fungus. It is commonly isolated as an upper respiratory tract saprophyte and is the most frequent contaminant in laboratory specimens. Because species of aspergillus are omnipresent, one must be cautious in ascribing a causal role to the fungus obtained from patients. Aspergillus has low pathogenicity for humans and animals and rarely invades the immunologically competent host. Although the fungus can affect any organ system, the respiratory tract is involved in >90% of afflicted patients. Pulmonary aspergillosis, depending whether the host is atopic or immunosuppressed, may be classified under four categories: allergic or hypersensitivity syndromes, saprophytic colonization, invasive (infective) dissemination, and chemical or toxic pneumonitis. These entities differ clinically, radiologically, immunologically, and in their response to various therapeutic agents. An increased awareness, an aggressive approach to securing the diagnosis, and instituting early and appropriate therapy are needed to reduce the high morbidity and mortality caused by many of the aspergillus-related syndromes.

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Section: Allergic Bronchopulmonary Aspergillosismentioning

confidence: 99%

Many faces of pulmonary aspergillosis

Sharma

Chwogule²

1998

Eur Respir J

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“…In some reports, the invasion by Aspergillus species is restricted to the tissues surrounding the bronchiectatic segments with granulomatous reaction [252][253][254]. Some of these cases are more likely to represent the semi-invasive form of CNA rather than IPA due to their chronic courses.…”

Section: Pulmonary Aspergillus Overlap Syndromesmentioning

confidence: 99%

Pulmonary aspergillosis: a clinical review

Kousha¹,

Tadi²,

Soubani³

2011

Eur Respir Rev

583

596

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Aspergillus is a mould which may lead to a variety of infectious, allergic diseases depending on the host's immune status or pulmonary structure. Invasive pulmonary aspergillosis occurs primarily in patients with severe immunodeficiency. The significance of this infection has dramatically increased with growing numbers of patients with impaired immune state associated with the management of malignancy, organ transplantation, autoimmune and inflammatory conditions; critically ill patients and those with chronic obstructive pulmonary disease appear to be at an increased risk. The introduction of new noninvasive tests, combined with more effective and better-tolerated antifungal agents, has resulted in lower mortality rates associated with this infection. Chronic necrotising aspergillosis is a locally invasive disease described in patients with chronic lung disease or mild immunodeficiency. Aspergilloma is usually found in patients with previously formed cavities in the lung, whereas allergic bronchopulmonary aspergillosis, a hypersensitivity reaction to Aspergillus antigens, is generally seen in patients with atopy, asthma or cystic fibrosis. This review provides an update on the evolving epidemiology and risk factors of the major manifestations of Aspergillus lung disease and the clinical manifestations that should prompt the clinician to consider these conditions. Current approaches for the diagnosis and management of these syndromes are discussed.

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“…The susceptibility of some individuals, particularly cystic fibrosis and asthmatic patients to develop ABPA is not fully understood. Some reports suggest that exposure to large concentrations of spores of A fumigatus may cause ABPA [7,8].…”

Section: Discussionmentioning

confidence: 99%

Allergic Bronchopulmonary Aspergillosis: A Diagnostic Challenge

Pokhare

Ylagan²,

Cheney³

2014

J Cytol Histol

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Allergic bronchopulmonary aspergillosis (ABPA) is an immunologic condition that results from an allergic immune response to Aspergillus fumigatus, most often occurring in a patient with bronchial asthma or cystic fibrosis. ABPA is diagnosed by constellation of clinical, laboratory, and radiographic criteria. In the absence of typical presentation, ABPA can be misdiagnosed. Our patient presented with a 3 cm right lower lobe lung mass and sub-centimeter right upper lobe lung nodules. The clinical features led to a presumptive diagnosis of lung carcinoma. The patient underwent preoperative bronchial washing and endobronchial biopsy. The washing sample showed large amount of thick mucus containing abundant eosinophils, Charcoat-Leyden crystals, and degenerated cellular debris consistent with "allergic mucin". These findings were initially overlooked and considered non-specific. Repeat sampling (needle biopsy) showed marked reactive pneumocyte hyperplasia in the background of inflammation, which was misdiagnosed as adenocarcinoma with lepidic growth pattern. The correct diagnosis was made only after the surgical resection of the lesion. Diagnosis of ABPA can be missed due to general unfamiliarity with this entity and its clinical presentation similar to the lung tumor. Accurate diagnosis can be derived from the bronchial washing if the features of "allergic mucin" are recognized and confirmed with microbiological examination.

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Allergic aspergillosis: review of 32 cases

Cited by 137 publications

References 22 publications

Many faces of pulmonary aspergillosis

Many faces of pulmonary aspergillosis

Pulmonary aspergillosis: a clinical review

Allergic Bronchopulmonary Aspergillosis: A Diagnostic Challenge

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