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
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
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Factors that may increase your chances of ABPA:
Symptoms of ABPA are usually those of progressive asthma. These include:
- Shortness of breath
- Chest pain
As ABPA progresses, other symptoms may occur:
- Production of thick, brownish, and/or bloody sputum
- Mild fever
- Unintended weight loss
You will be asked 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:
- Chest x-ray
- CT scan
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.
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—may be taken by mouth or inhaled depending on the severity of the symptoms
- Antifungal drugs
- Medications used for asthma, such as bronchodilators or other anti-allergy medication
Avoiding exposure to fungus is the best way to prevent ABPA. However, this is difficult because fungus 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
American Lung Association
Centers for Disease Control and Prevention
Allergic bronchopulmonary aspergillosis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115466/Allergic-bronchopulmonary-aspergillosis. Updated January 6, 2017. Accessed December 11, 2017.
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. Accessed December 11, 2017.
Wark PA, Gibson PG, Wilson AJ. Azoles for allergic bronchopulmonary aspergillosis associated with asthma. Cochrane Database Syst Rev 2004;(3): CD001108.
Last reviewed November 2018 by EBSCO Medical Review Board David L. Horn, MD, FACP Last Updated: 12/20/2014