Allergic Bronchopulmonary Aspergillosis (ABPA)
Allergic bronchopulmonary aspergillosis (ABPA) is a rare allergic lung problem. In some people, it can lead to lung damage.
ABPA is caused by an allergy to an inhaled fungus that grows in decaying plants, soil, certain foods, dust, and water. The fungus settles in the lungs when a person breathes it in. This causes:
- Sensitivity to the fungus
- Repeat inflammation of the lungs, due to the allergy
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Other things that raise the risk are:
Symptoms of ABPA vary from mild to severe. They may be:
- Coughing that may produce mucus that is thick, black, brown, or bloody
- Problems breathing, such as wheezing
- Feeling tired and weak
- Weight loss
- Mild fever
The doctor will ask about your symptoms and past health. A physical exam will be done. You may be referred to a lung doctor.
Tests may include:
- Blood tests
- Skin prick tests—to check for a reaction to the fungus
- Sputum tests—to look for the fungus
Images may be taken to look for lung problems. They may include:
- Chest x-ray
- CT scan
If the diagnosis is not clear, a scope may be used to view the airway and get a tissue sample. This can be done with bronchoscopy.
Pulmonary function tests (PFTs) may be done to monitor the disease.
ABPA is often diagnosed after several positive tests for ABPA.
The goals of ABPA treatment are to:
- Control symptoms of chronic conditions, such as asthma and cystic fibrosis
- Prevent worsening of ABPA
- Ease lung inflammation
- Avoid severe lung disease
Medicines that may be given include:
- Steroids—taken by mouth, inhaler or IV
- Antifungal drugs—to kill the fungus
- Bronchodilators—to open the airways
- Other anti-allergy medicines
There are no current guidelines to prevent ABPA.
- Allergic bronchopulmonary aspergillosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/allergic-bronchopulmonary-aspergillosis .
- Allergic bronchopulmonary aspergillosis (ABPA). American Academy of Allergy Asthma & Immunology website. Available at: http://www.aaaai.org/conditions-and-treatments/related-conditions/allergic-bronchopulmonary-aspergillosis.
- Patel G, Greenberger PA. Allergic bronchopulmonary aspergillosis. Allergy Asthma Proc. 2019;40(6):421-424.
- David L. Horn, MD, FACP
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