Chronic Hypersensitivity Pneumonitis Caused by Aspergillus Complicated with Pulmonary Aspergilloma

Yoshimoto, Akihiro; Ichikawa, Yasumitsu; Waseda, Yuko; Yasui, Masahide; Fujimura, Masaki; Hebisawa, Akira; Nakao, Shinji

doi:10.2169/internalmedicine.43.982

Cited by 9 publications

(6 citation statements)

References 11 publications

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“…As CPA often arises in preformed cavities, it can also complicate other conditions which cause lung injury such as cryptococcosis and radiation therapy respectively . Furthermore, aspergilloma has been reported to be associated with chronic hypersensitivity pneumonitis …”

Section: Epidemiology and Pathogenesismentioning

confidence: 99%

“…28,29 Furthermore, aspergilloma has been reported to be associated with chronic hypersensitivity pneumonitis. 30 According to the predisposing conditions, most cases of CPA occur in middle-aged patients, 5,7 but young CF patients 31,32 as well as younger adults, e.g. with history of tuberculosis 9 may be affected, too.…”

Section: Epidemiology and Pathogenesismentioning

confidence: 99%

“…It remains difficult to interpret the succession of chronic allergic and chronic fungal pulmonary disease. One may ask: Is the case report of chronic hypersensitive pneumonitis (CHP) complicated by the finding of an aspergilloma or did the long‐term Aspergillus exposure from the aspergilloma cause CHP?…”

Section: Treatment Options and Prognosismentioning

confidence: 99%

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Chronic pulmonary aspergillosis

Schweer,

Bangard,

Hekmat

et al. 2013

Mycoses

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Summary Chronic pulmonary aspergillosis (CPA) is a group of consuming diseases usually presenting with prolonged and relapsing cough, dyspnoea and weight loss. Acute symptoms such as haemoptysis and bronchial or pulmonary haemorrhage may occasionally occur. CPA affects patients with underlying pulmonary conditions, for example, chronic obstructive pulmonary disease or mycobacteriosis or common immunosuppressive conditions such as diabetes. Precise epidemiology is unknown, and while prevalence is considered low the chronic and relapsing nature of the disease challenges the treating physician. Diagnostics largely rely on serologic Aspergillus precipitins and findings on thoracic computed tomography. The latter are manifold comprising cavity formation, pleural involvement and sometimes aspergilloma. Other markers for aspergillosis are less helpful, in part due to the non‐ or semi‐invasive nature of these forms of Aspergillus infection. Various antifungals were shown to be effective in CPA treatment. Azoles are the most frequently applied antifungals in the outpatient setting, but are now compromised by findings of Aspergillus resistance. Long‐term prognosis is not fully elucidated and may be driven by the underlying morbidities. Prospective registry‐type studies may be suitable to systematically broaden our CPA knowledge base. This article gives an overview of the available literature and proposes a clinical working algorithm for CPA management.

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Section: Epidemiology and Pathogenesismentioning

confidence: 99%

Section: Epidemiology and Pathogenesismentioning

confidence: 99%

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Chronic pulmonary aspergillosis

Schweer,

Bangard,

Hekmat

et al. 2013

Mycoses

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“…Serological testing is used in the diagnosis of ABPA as well as invasive infection. Precipitating antibodies are typically present in ABPA and chronic cavitary pulmonary aspergillosis but not necessarily so during invasive infection of the immunosuppressed host [13]. On the other hand Aspergillus galactomannan antigen, a major component of the cell wall of Aspergillus, is detectable in the majority of cases of invasive pulmonary aspergillosis in those with underlying haematological disease and intensive care [14], and notably was also found in case 1 in high titre in a serum sample taken at the time of admission, consistent with (perhaps diagnostic of) invasive infection at this early time point.…”

Section: Discussionmentioning

confidence: 99%

Acute pulmonary aspergillosis in immunocompetent subjects after exposure to bark chippings

Arendrup¹,

O’Driscoll²,

Petersen³

et al. 2006

Scandinavian Journal of Infectious Diseases

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“…Finally, endogenous antigens associated with clinical infection may also induce HP. Y oshimoto et al [ 58 ] reported a case of HP precipitated by Aspergillus from an infectious aspergilloma, while S chreiber et al [ 59 ] described a case of HP caused by endogenous Candida albicans .…”

Section: Type Of Exposurementioning

confidence: 99%

Exposure assessment in hypersensitivity pneumonitis: a comprehensive review and proposed screening questionnaire

Petnak

Moua

2020

ERJ Open Res

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Hypersensitivity pneumonitis is an immune-mediated inflammatory lung disease characterised by the inhalation of environmental antigens leading to acute and chronic lung injury. Along with suggestive clinical and radiological findings, history and timing of suspected antigen exposure are important elements for diagnostic confidence. Unfortunately, many diagnoses remain tentative and based on vague and imprecise environmental or material exposure histories. To date, there has not been a comprehensive report highlighting the frequency and type of environmental exposure that might lead to or support a more systematic approach to antigen identification. We performed a comprehensive literature review to identify and classify causative antigens and their associated environmental contexts or source materials, with emphasis on the extent of the supportive literature for each exposure type. Eligible publications were those that reported unique inciting antigens and their respective environments or contexts. A clinical questionnaire was then proposed based on this review to better support diagnosis of hypersensitivity pneumonitis when antigen testing or other clinical and radiological variables are inconclusive or incomplete.

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Chronic Hypersensitivity Pneumonitis Caused by Aspergillus Complicated with Pulmonary Aspergilloma

Cited by 9 publications

References 11 publications

Chronic pulmonary aspergillosis

Chronic pulmonary aspergillosis

Acute pulmonary aspergillosis in immunocompetent subjects after exposure to bark chippings

Exposure assessment in hypersensitivity pneumonitis: a comprehensive review and proposed screening questionnaire

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