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Allergic Bronchopulmonary Aspergillosis (ABPA)

  • Definition

    Allergic bronchopulmonary aspergillosis (ABPA) is an allergic lung disorder. It is related to a fungus. Aspergillosis can also occur as:
    • A lung infection that can spread to other parts of the body, which is more common in patients with suppressed immune systems
    • A fungal growth in a lung cavity that has healed from a previous lung disease or infection
  • Causes

    ABPA is caused by an allergic reaction to an inhaled fungus. It grows and flourishes in decaying vegetation, soil, certain foods, dust, and water. The inhaled fungus colonizes mucus in the lungs, causing:
    • Sensitization to the fungus
    • Recurring allergic inflammation of the lungs
    • Packing of the tiny alveoli air sacs in the lungs with a type of white blood cell involved in certain allergic reactions and infections with parasites
    Healthy Alveoli
    Alveoli
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  • Risk Factors

    Risk factors that increase your chances of getting ABPA include:
  • Symptoms

    Symptoms of ABPA are usually those of progressive asthma. These include:
    • Shortness of breath
    • Cough
    • Wheezing
    • Weakness
    • Chest pain
    As ABPA progresses, other symptoms may occur, including:
    • Production of thick, brownish, and/or bloody sputum
    • Mild fever
    • Unintended weight loss
  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done.
    Images may be taken of your bodily structures. This can be done with:
    Your bodily fluids and tissues may be tested. This can be done with:
    • Sputum tests
    • Blood tests
    • Skin prick tests
    • Biopsy of lung or sinus tissue
    Your lungs may be tested. This can be done with pulmonary function tests (PFTs) .
    ABPA can appear quite similar to non-ABPA induced asthma. ABPA is typically diagnosed after several repeat tests for ABPA are positive over a number of months or years.
  • Treatment

    The goals of treatment include:
    • Suppressing the allergic reaction to the fungus
    • Minimizing lung inflammation
    • Preventing the fungus from colonizing the lungs
    ABPA is usually treated with:
    • Steroids
    • Antifungal drugs
  • Prevention

    Avoiding exposure to fungus is the best way to prevent ABPA. However, this is difficult, because fugus is so prevalent in the environment. Guidelines to help prevent exposure to the fungus include:
    • Avoiding areas with:
      • Decaying vegetation
      • Standing water
    • Keeping your home as dust-free as possible
    • Remaining in air-filtered, air-conditioned environments whenever possible
    Measures to avoid symptoms and prevent permanent lung damage caused by ABPA include:
    • Ongoing testing and monitoring of ABPA
    • Early and continuing medical treatment for the disease
  • RESOURCES

    American Lung Association http://www.lungusa.org

    Centers for Disease Control and Prevention (CDC) http://www.cdc.gov

    CANADIAN RESOURCES

    The Canadian Lung Association http://www.lung.ca

    Health Canada http://www.hc-sc.gc.ca

    References

    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.aspx. ;Accessed September 17, 2013.

    Allergic bronchopulmonary aspergillosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 17, 2013. Accessed September 17, 2013.

    Wark PA, Gibson PG, Wilson AJ. Azoles for allergic bronchopulmonary aspergillosis associated with asthma. Cochrane Database Syst Rev 2004; (3): CD001108.

    Revision Information

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