Allergic Bronchopulmonary Aspergillosis Coupled with Broncholithiasis in a Non-asthmatic Patient

Abstract

Allergic bronchopulmonary aspergillosis (ABPA), an asthmatic disease, is caused primarily by hypersensitivity to Aspergillus species. ABPA is rarely observed in the absence of asthma, which is, in fact, the principle criterion for its diagnosis. Here, we report the case of a 36-yr-old woman without a history of bronchial asthma, who manifested a localized pneumonic consolidation, coupled with broncholithiasis. Pathologic examinations of bronchoscopic biopsy specimens and resected surgical specimens revealed features typical of ABPA. This is a very rare case of ABPA coupled with broncholithiasis in a non-asthmatic individual.

Bronchocele, a common but underrecognized condition: a systematic review

“…The high density of HAM has been attributed to calcium oxalate deposition. Other contents like iron, manganese, calcium phosphate, calcium sulphate are also proposed as causative factors of high attenuation as seen in allergic fungal sinusitis and airway disease, sinobronchial allergic mycosis (SAM) [21][22][23]. In the author's opinion ABPA is a common but underrecognized cause of bronchocele and if it's present in asthmatics, a workup is needed accordingly with IgE levels, Aspergillus serology and imaging since management differs in both conditions.…”

Allergic aspergillosis of the respiratory tract

“…This could be attributed to the absence of clinical asthma and the remarkable radiological similarities to pulmonary tuberculosis. A patient with ABPA without asthma but with bronchlithiasis was also described from Korea [83].…”

“…In 1981, GLANCY et al [78] described the first such patient. Since then approximately a score of patients with ABPA without asthma have been reported [79][80][81][82][83]. On the basis of their clinical and radiological findings, more than half of these patients were initially investigated for bronchogenic carcinoma while one patient was referred for evaluation of multidrug-resistant tuberculosis [82].…”

Allergic Bronchopulmonary Aspergillosis Coupled with Sinusitis in a Nonasthmatic Patient

“…Bronchial asthma has classically been considered an essential diagnostic criterion for ABPA, and has also been believed to play a crucial role in its development 1 . However, a few cases of ABPA have been reported in nonasthmatic patients, but they are rare, with less than 20 cases having ever been described in the literature [5][6][7] . However, in those reports, some of the patients were in a pre-asthmatic state and ultimately developed bronchial asthma.…”