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Allergic Bronchopulmonary Aspergillosis (ABPA)

Definition

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

Causes

ABPA is caused by an allergy to an inhaled fungus. The fungus grows in decaying plants, soil, certain foods, dust, and water. When inhaled, the fungus can settle in the lungs. This causes:

  • Sensitivity to the fungus
  • Repeat inflammation of the lungs, due to the allergy

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Risk Factors

ABPA is more common in adults. However, it can occur in children. Other things that raise the risk are:

Symptoms

Symptoms of ABPA vary from mild to life-threatening. They may be:

  • New or worsening cough
  • Problems breathing
  • Coughing up mucus that is thick, black, brown, or bloody
  • Wheezing
  • Feeling tired and weak
  • Weight loss
  • Mild fever

Diagnosis

The doctor will ask about your symptoms and health history. 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:

If the diagnosis is unclear, bronchoscopy may be used to look at the airway and get a tissue sample.

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 treatment are to:

  • Control symptoms of asthma and cystic fibrosis
  • Prevent worsening of ABPA
  • Reduce lung inflammation
  • Avoid severe lung disease

Medicines to treat ABPA may be:

  • Steroids—taken by mouth, inhaler or IV
  • Antifungal drugs—to kills the fungus
  • Bronchodilators—to open the airways
  • Other anti-allergy medicines

Prevention

There are no current guidelines to prevent ABPA.

RESOURCES:

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

Centers for Disease Control and Prevention
https://www.cdc.gov

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

The Lung Association
https://www.lung.ca

REFERENCES:

Allergic bronchopulmonary aspergillosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/allergic-bronchopulmonary-aspergillosis . Accessed March 30, 2021.

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 March 30, 2021.

Patel G, Greenberger PA. Allergic bronchopulmonary aspergillosis. Allergy Asthma Proc. 2019;40(6):421-424.

Last reviewed December 2020 by EBSCO Medical Review Board David L. Horn, MD, FACP  Last Updated: 3/30/2021