Allergic bronchopulmonary aspergillosis

Agarwal, Ritesh; Sehgal, InderpaulS; Dhooria, Sahajal; Muthu, Valliappan; Prasad, KuruswamyT; Bal, Amanjit; Aggarwal, AshutoshN; Chakrabarti, Arunaloke

doi:10.4103/ijmr.ijmr_1187_19

Cited by 78 publications

(100 citation statements)

References 160 publications

(229 reference statements)

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“…We manage ABPA exacerbations with either oral glucocorticoids (as above), or itraconazole (200 mg twice daily for 6 months), or voriconazole (200 mg twice daily for 6 months) or a combination of glucocorticoid with an azole (Figure 1). 18 …”

Section: Methodsmentioning

confidence: 99%

“…17 In the non-pregnant women, we diagnose ABPA exacerbation as a 50% increase in serum total IgE along with persistent worsening of respiratory symptoms (despite 5 days of oral glucocorticoids) or new findings on imaging (Figure 1). We manage ABPA exacerbations with either oral glucocorticoids (as above), or itraconazole (200 mg twice daily for 6 months), or voriconazole (200 mg twice daily for 6 months) or a combination of glucocorticoid with an azole(Figure 1) 18.…”

mentioning

confidence: 99%

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Pregnancy complicated by allergic bronchopulmonary aspergillosis: A case‐control study

Sehgal

Dhooria

Prasad

et al. 2020

Mycoses

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Background: Whether allergic bronchopulmonary aspergillosis (ABPA) affects maternal and perinatal outcomes during pregnancy or vice versa is unknown. Objective: To evaluate the course of ABPA and its consequence on maternal and perinatal outcomes during pregnancy. Methods: We retrospectively included pregnant women with ABPA (cases) and compared them with non-pregnant ABPA subjects (controls). We recorded the following details in cases and controls: demographical characteristics, radiological findings, pulmonary function, duration of symptoms and the number of asthma and ABPA exacerbations during follow-up. We also recorded the maternal and perinatal outcomes in the cases. Results: We included nine cases and 38 controls with a similar age range. All the cases had achieved remission of ABPA before pregnancy and were receiving inhaled medications for asthma control. Serum total IgE levels, the extent of bronchiectasis on CT thorax and pulmonary function were comparable in the two groups. The mean number of asthma (53 vs 7) and ABPA (62 vs 16) exacerbations per 100 person-years was significantly higher in cases compared to the controls. We did not observe any maternal complications. One neonate had low birthweight. Conclusions: The risk of asthma and ABPA exacerbations is significantly higher in pregnant subjects with ABPA than non-pregnant women with ABPA. However, maternal and perinatal outcomes are good.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Pregnancy complicated by allergic bronchopulmonary aspergillosis: A case‐control study

Sehgal

Dhooria

Prasad

et al. 2020

Mycoses

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“…In contrast, allergic diseases, characterized by a T H 2-driven immune response to Aspergillus antigens, include both severe asthma with fungal sensitization (SAFS) and allergic bronchopulmonary aspergillosis (ABPA). Both SAFS and ABPA are significant clinical issues in patients with asthma, with the latter being a significant clinical problem in patients with CF [ 7 , 8 ]. A. fumigatus is the common cause of ABPA, however sensitization to other Aspergillus species has been noted [ 9 ].…”

Section: Pulmonary Aspergillus Infectionsmentioning

confidence: 99%

“…Chronic aspergillosis and ABPA affect a large number of patients each year, with more than 3 million cases of chronic disease and nearly 5 million cases of ABPA reported on an annual basis [ 7 , 13 ]. The majority of ABPA represents disease in asthmatics, with an estimated 1 to 2.5% of all asthmatics worldwide having ABPA [ 14 ].…”

Section: Prevalence and Diagnosis Of Aspergillus Infections In Patients With Cfmentioning

confidence: 99%

Allergic Diseases Caused by Aspergillus Species in Patients with Cystic Fibrosis

Curran

Hava

2021

Antibiotics

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Aspergillus spp. are spore forming molds; a subset of which are clinically relevant to humans and can cause significant morbidity and mortality. A. fumigatus causes chronic infection in patients with chronic lung disease such as asthma, chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF). In patients with CF, A. fumigatus infection can lead to allergic disease, such as allergic bronchopulmonary aspergillosis (ABPA) which is associated with high rates of hospitalizations for acute exacerbations and lower lung function. ABPA results from TH2 immune response to Aspergillus antigens produced during hyphal growth, marked by high levels of IgE and eosinophil activation. Clinically, patients with ABPA experience difficulty breathing; exacerbations of disease and are at high risk for bronchiectasis and lung fibrosis. Oral corticosteroids are used to manage aspects of the inflammatory response and antifungal agents are used to reduce fungal burden and lower the exposure to fungal antigens. As the appreciation for the severity of fungal infections has grown, new therapies have emerged that aim to improve treatment and outcomes for patients with CF.

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“…Other secondary causes of immunodeficiency include hematological malignancy, drug-induced immunosuppression, and post-allogenic bone marrow transplantation [ 20 , 21 ]. Finally, a mixed hypersensitivity reaction, including type I, III, and IV features, characterizes the inflammatory damage found in allergic bronchopulmonary aspergillosis, a condition frequently associated to bronchiectasis [ 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial Resistance in Common Respiratory Pathogens of Chronic Bronchiectasis Patients: A Literature Review

et al. 2021

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Non-cystic fibrosis bronchiectasis is a chronic disorder in which immune system dysregulation and impaired airway clearance cause mucus accumulation and consequent increased susceptibility to lung infections. The presence of pathogens in the lower respiratory tract causes a vicious circle resulting in impaired mucociliary function, bronchial inflammation, and progressive lung injury. In current guidelines, antibiotic therapy has a key role in bronchiectasis management to treat acute exacerbations and chronic infection and to eradicate bacterial colonization. Contrastingly, antimicrobial resistance, with the risk of multidrug-resistant pathogen development, causes nowadays great concern. The aim of this literature review was to assess the role of antibiotic therapy in bronchiectasis patient management and possible concerns regarding antimicrobial resistance based on current evidence. The authors of this review stress the need to expand research regarding bronchiectasis with the aim to assess measures to reduce the rate of antimicrobial resistance worldwide.

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Allergic bronchopulmonary aspergillosis

Cited by 78 publications

References 160 publications

Pregnancy complicated by allergic bronchopulmonary aspergillosis: A case‐control study

Pregnancy complicated by allergic bronchopulmonary aspergillosis: A case‐control study

Allergic Diseases Caused by Aspergillus Species in Patients with Cystic Fibrosis

Antimicrobial Resistance in Common Respiratory Pathogens of Chronic Bronchiectasis Patients: A Literature Review

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