Allergic Bronchopulmonary Aspergillosis (ABPA)

Definition

Allergic bronchopulmonary aspergillosis (ABPA) is a rare allergic lung problem. In some people, it can lead to lung damage.

Causes

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

Healthy Alveoli.

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Risk Factors

ABPA is more common in adults. It is also more common in people who have asthma or cystic fibrosis.

Other things that raise the risk are:

• A personal or family history of allergies or atopic dermatitis
• COPD
• Previous tuberculosis

Symptoms

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

Diagnosis

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.

Treatment

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

Prevention

There are no current guidelines to prevent ABPA.