VA Resident Report: Review of Allergic Bronchopulmonary Aspergillosis

In susceptible individuals, inhalation of Aspergillus spores can affect the respiratory tract  in many ways. These spores get trapped in the viscid sputumof asthmatic subjects which triggers a cascade of inflammatory reactions that can result in Aspergillus-induced asthma, allergic bronchopulmonary aspergillosis, and allergic Aspergillus sinusitis. An immunologically mediated disease, ABPA, occurs predominantly in patients with asthma and cystic fibrosis.

Shah, A., & Panjabi, C. (n.d.). Allergic Bronchopulmonary Aspergillosis: A Perplexing Clinical Entity. Allergy, Asthma & Immunology Research., 8(4), 282-297.

Once the disease was recognized in the United States in 1968 and thence globally, the key diagnostic features have been standardized. Based on clinical, radiologic, and laboratory features, a set of 8 major and 3 minor criteria was proposed in 1977 by Rosenberg and Patterson, which remains the most well-acknowledged criteria.

Table 2. Evolving diagnostic criteria for ABPA  Page 285

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