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Allergic Bronchopulmonary Aspergillosis
Allen Heeger, DO
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Allergic bronchopulmonary aspergillosis (ABPA)
              • Definitions

                • ABPA: Chronic airway inflammation and injury in patients with hypersensitivity to Aspergillus antigens
                  • Allergic response to inhaled Aspergillus spores
                  • Typically affects patients with asthma and cystic fibrosis
                • Allergic bronchopulmonary mycoses: Chronic airway inflammation/injury due to hypersensitivity to other fungi
                • Serological ABPA (ABPA-S): Mild form of disease with positive serology and other criteria, but without bronchiectasis

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • Imaging Recommendations

                      • MR Findings

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        Selected References

                                        1. Agarwal R et al: Allergic bronchopulmonary aspergillosis. Indian J Med Res. 151(6):529-49, 2020
                                        2. Asano K et al: New clinical diagnostic criteria for allergic bronchopulmonary aspergillosis/mycosis and its validation. J Allergy Clin Immunol. 147(4):1261-8.e5, 2020
                                        3. Lu HW et al: The clinical characteristics and prognosis of ABPA are closely related to the mucus plugs in central bronchiectasis. Clin Respir J. 14(2):140-7, 2020
                                        4. Russo A et al: Pulmonary aspergillosis: an evolving challenge for diagnosis and treatment. Infect Dis Ther. 9(3):511-24, 2020
                                        5. Latgé JP et al: Aspergillus fumigatus and Aspergillosis in 2019. Clin Microbiol Rev. 33(1), 2019
                                        6. Dournes G et al: Allergic bronchopulmonary aspergillosis in cystic fibrosis: MR imaging of airway mucus contrasts as a tool for diagnosis. Radiology. 285(1):261-9, 2017
                                        7. Phuyal S et al: High-attenuation mucus impaction in patients with allergic bronchopulmonary aspergillosis: objective criteria on high-resolution computed tomography and correlation with serologic parameters. Curr Probl Diagn Radiol. 45(3):168-73, 2016
                                        8. Shah A et al: Allergic bronchopulmonary aspergillosis: a perplexing clinical entity. Allergy Asthma Immunol Res. 8(4):282-97, 2016
                                        9. Chabi ML et al: Pulmonary aspergillosis. Diagn Interv Imaging. 96(5):435-42, 2015
                                        10. Kaur M et al: Allergic bronchopulmonary Aspergillosis (ABPA)-the high resolution computed tomography (HRCT) chest imaging scenario. J Clin Diagn Res. 8(6):RC05-7, 2014
                                        11. Agarwal R et al: Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria. Clin Exp Allergy. 43(8):850-73, 2013
                                        12. Greenberger PA: When to suspect and work up allergic bronchopulmonary aspergillosis. Ann Allergy Asthma Immunol. 111(1):1-4, 2013
                                        13. Agarwal R et al: Chest radiographic and computed tomographic manifestations in allergic bronchopulmonary aspergillosis. World J Radiol. 4(4):141-50, 2012
                                        14. Bains SN et al: Allergic bronchopulmonary aspergillosis. Clin Chest Med. 33(2):265-81, 2012
                                        15. Agarwal R et al: Pictorial essay: allergic bronchopulmonary aspergillosis. Indian J Radiol Imaging. 21(4):242-52, 2011
                                        16. Greene R: The radiological spectrum of pulmonary aspergillosis. Med Mycol. 43 Suppl 1:S147-54, 2005
                                        17. Moss RB: Pathophysiology and immunology of allergic bronchopulmonary aspergillosis. Med Mycol. 43 Suppl 1:S203-6, 2005
                                        18. Franquet T et al: Aspergillus infection of the airways: computed tomography and pathologic findings. J Comput Assist Tomogr. 28(1):10-6, 2004
                                        19. Khan AN et al: Bronchopulmonary aspergillosis: a review. Curr Probl Diagn Radiol. 32(4):156-68, 2003
                                        20. Gotway MB et al: The radiologic spectrum of pulmonary Aspergillus infections. J Comput Assist Tomogr. 26(2):159-73, 2002
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Allergic bronchopulmonary aspergillosis (ABPA)
                                                    • Definitions

                                                      • ABPA: Chronic airway inflammation and injury in patients with hypersensitivity to Aspergillus antigens
                                                        • Allergic response to inhaled Aspergillus spores
                                                        • Typically affects patients with asthma and cystic fibrosis
                                                      • Allergic bronchopulmonary mycoses: Chronic airway inflammation/injury due to hypersensitivity to other fungi
                                                      • Serological ABPA (ABPA-S): Mild form of disease with positive serology and other criteria, but without bronchiectasis

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • Imaging Recommendations

                                                            • MR Findings

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              Selected References

                                                                              1. Agarwal R et al: Allergic bronchopulmonary aspergillosis. Indian J Med Res. 151(6):529-49, 2020
                                                                              2. Asano K et al: New clinical diagnostic criteria for allergic bronchopulmonary aspergillosis/mycosis and its validation. J Allergy Clin Immunol. 147(4):1261-8.e5, 2020
                                                                              3. Lu HW et al: The clinical characteristics and prognosis of ABPA are closely related to the mucus plugs in central bronchiectasis. Clin Respir J. 14(2):140-7, 2020
                                                                              4. Russo A et al: Pulmonary aspergillosis: an evolving challenge for diagnosis and treatment. Infect Dis Ther. 9(3):511-24, 2020
                                                                              5. Latgé JP et al: Aspergillus fumigatus and Aspergillosis in 2019. Clin Microbiol Rev. 33(1), 2019
                                                                              6. Dournes G et al: Allergic bronchopulmonary aspergillosis in cystic fibrosis: MR imaging of airway mucus contrasts as a tool for diagnosis. Radiology. 285(1):261-9, 2017
                                                                              7. Phuyal S et al: High-attenuation mucus impaction in patients with allergic bronchopulmonary aspergillosis: objective criteria on high-resolution computed tomography and correlation with serologic parameters. Curr Probl Diagn Radiol. 45(3):168-73, 2016
                                                                              8. Shah A et al: Allergic bronchopulmonary aspergillosis: a perplexing clinical entity. Allergy Asthma Immunol Res. 8(4):282-97, 2016
                                                                              9. Chabi ML et al: Pulmonary aspergillosis. Diagn Interv Imaging. 96(5):435-42, 2015
                                                                              10. Kaur M et al: Allergic bronchopulmonary Aspergillosis (ABPA)-the high resolution computed tomography (HRCT) chest imaging scenario. J Clin Diagn Res. 8(6):RC05-7, 2014
                                                                              11. Agarwal R et al: Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria. Clin Exp Allergy. 43(8):850-73, 2013
                                                                              12. Greenberger PA: When to suspect and work up allergic bronchopulmonary aspergillosis. Ann Allergy Asthma Immunol. 111(1):1-4, 2013
                                                                              13. Agarwal R et al: Chest radiographic and computed tomographic manifestations in allergic bronchopulmonary aspergillosis. World J Radiol. 4(4):141-50, 2012
                                                                              14. Bains SN et al: Allergic bronchopulmonary aspergillosis. Clin Chest Med. 33(2):265-81, 2012
                                                                              15. Agarwal R et al: Pictorial essay: allergic bronchopulmonary aspergillosis. Indian J Radiol Imaging. 21(4):242-52, 2011
                                                                              16. Greene R: The radiological spectrum of pulmonary aspergillosis. Med Mycol. 43 Suppl 1:S147-54, 2005
                                                                              17. Moss RB: Pathophysiology and immunology of allergic bronchopulmonary aspergillosis. Med Mycol. 43 Suppl 1:S203-6, 2005
                                                                              18. Franquet T et al: Aspergillus infection of the airways: computed tomography and pathologic findings. J Comput Assist Tomogr. 28(1):10-6, 2004
                                                                              19. Khan AN et al: Bronchopulmonary aspergillosis: a review. Curr Probl Diagn Radiol. 32(4):156-68, 2003
                                                                              20. Gotway MB et al: The radiologic spectrum of pulmonary Aspergillus infections. J Comput Assist Tomogr. 26(2):159-73, 2002