Showing posts with label ABPA. Show all posts
Showing posts with label ABPA. Show all posts


ABPA is a disease state induced by arthus reaction to colonizing aspergillus in the bronchi in patients with bronchial asthma.
Clinical Picture
  • ABPA should be suspected whenever asthma is refractory and is associated with fever, cough and black or grey sputum.
  • Chest x-ray often reveals evanescent pulmonary infiltrates.
  • Marked eosinophilia and elevated IgE are noted.
  • Aspergillus colonizes in the bronchi in asthmatics because of thick secretions. A precipitating antibody is produced. A type III immunological reaction follows. Complement is activated. An inflammatory response occurs with damage to the bronchial wall and the bronchi get plugged with secretion. Segmental infiltrates and atelectasis follows.
  • Aspergillus precipitating antibody is detected in serum.
  • IgE levels and eosinophiles are elevated.
  • Central bronchiectasis can be demonstrated by CT scan.

  • ABPA responds to systemic steroids.
  • Dose and duration of steroids can be adjusted by following serum IgE levels.