Allergic Bronchopulmonary Aspergillosis

• Published in: The journal of allergy and clinical immunology in practice (Cambridge, MA) Vol. 5; no. 3; pp. 866 - 867
• Main Authors: Reddy, Ashwini, MD, Greenberger, Paul A., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2017; Elsevier Limited
• Subjects: Accreditation; Adolescent; Allergic bronchopulmonary aspergillosis; Allergies; Allergy and Immunology; Antibodies; Antibodies, Fungal - blood; Aspergillosis; Aspergillosis, Allergic Bronchopulmonary - diagnosis; Aspergillosis, Allergic Bronchopulmonary - drug therapy; Aspergillus fumigatus - immunology; Asthma; Asthma - diagnosis; Asthma - drug therapy; Chest; Copyright; Cystic fibrosis; Cystic Fibrosis - diagnosis; Cystic Fibrosis - drug therapy; Eosinophilia; Food allergies; Fungal infections; Health education; Humans; Immunoglobulin E; Immunoglobulin E - blood; Immunoglobulin G; Immunoglobulins; Immunological tolerance; Immunology; Immunosuppressive agents; Infectious diseases; Internal Medicine; Itraconazole - therapeutic use; Lung diseases; Male; Medical research; Patients; Prednisone - therapeutic use; Pulmonary arteries; Remission; Skin Tests; Steroids; Allergic bronchopulmonary aspergillosis; Cystic fibrosis
• ISSN: 2213-2198; 2213-2201
• DOI: 10.1016/j.jaip.2016.08.019

Accreditation/Provider Statements and Credit Designation: The American Academy of Allergy, Asthma & Immunology (AAAAI) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. P. A. Greenberger is on the World Allergy Organization Board of Directors; has received consultancy fees from Allergy Therapeutics and the Food and Drug Administration, Pulmonary Allergy Drugs Advisory Committee; has provided expert testimony, none of which are related to this report; has received research support from Amgen, National Institute of Allergy and Infectious Disease, and Immune Tolerance Network; and receives royalties from Wolters Kluwer Lippincott, Williams & Wilkins, and UpToDate. Given its high prevalence in a common patient population seen in allergist offices, this diagnosis should be considered in patients with pulmonary eosinophilia/tenacious mucous plugging, infiltrates on chest x-ray, and positive skin/serologic testing.1,2 The precise minimal criteria of ABPA would be defined as follows: (1) asthma/CF, (2) positive skin test to Aspergillus sp., (3) IgE > 417 IU/mL (or kU/L), (4) increased specific IgE or IgG Aspergillus sp. antibodies, and (5) infiltrates on chest x-ray. A reduction of total IgE concentration by 50% along with clearing of infiltrates represents progression towards remission.5 Other therapies such as environmental/behavioral...