Document Detail


Allergic bronchopulmonary aspergillosis.
MedLine Citation:
PMID:  20463254     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Allergic bronchopulmonary aspergillosis (ABPA) is a complex clinical entity that results from an allergic immune response to Aspergillus fumigatus, most often occurring in a patient with asthma or cystic fibrosis. Sensitization to aspergillus in the allergic host leads to activation of T helper 2 lymphocytes, which play a key role in recruiting eosinophils and other inflammatory mediators. ABPA is defined by a constellation of clinical, laboratory, and radiographic criteria that include active asthma, serum eosinophilia, an elevated total IgE level, fleeting pulmonary parenchymal opacities, bronchiectasis, and evidence for sensitization to Aspergillus fumigatus by skin testing. Specific diagnostic criteria exist and have evolved over the past several decades. Staging can be helpful to distinguish active disease from remission or end-stage bronchiectasis with progressive destruction of lung parenchyma and loss of lung function. Early recognition allows treatment with corticosteroids, which are effective but may be required indefinitely. There is some evidence to support the use of newer antifungal azoles as corticosteroid-sparing agents. Patients must be followed closely for recurrent disease. ABPA should be considered in all patients with asthma or cystic fibrosis, but especially in those with difficult to control disease.
Authors:
Karen Patterson; Mary E Strek
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Proceedings of the American Thoracic Society     Volume:  7     ISSN:  1943-5665     ISO Abbreviation:  Proc Am Thorac Soc     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-13     Completed Date:  2010-08-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101203596     Medline TA:  Proc Am Thorac Soc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  237-44     Citation Subset:  IM    
Affiliation:
Department of Medicine, Section of Pulmonary and Critical Care Medicine, The University of Chicago, Chicago, IL 60637, USA.
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Monoclonal / therapeutic use
Antifungal Agents / therapeutic use
Aspergillosis, Allergic Bronchopulmonary / diagnosis*,  drug therapy,  immunology,  physiopathology,  radiography
Disease Susceptibility
Glucocorticoids / adverse effects,  therapeutic use
Humans
Immunoglobulin E / blood
Lymphocyte Activation / immunology
Pyrimidines / therapeutic use
Respiratory Function Tests
T-Lymphocytes, Helper-Inducer / immunology
Tomography, X-Ray Computed
Treatment Outcome
Triazoles / therapeutic use
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antifungal Agents; 0/Glucocorticoids; 0/Pyrimidines; 0/Triazoles; 0/voriconazole; 37341-29-0/Immunoglobulin E

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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