Allergic Bronchopulminary Aspergillosis

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Allergic Bronchopulminary Aspergillosis (ABPA) is a medical condition in which the immune system displays an abnormal response to aspergillus, which is a genus of more than 200 molds that are commonly found in all areas of the world. This condition is more pronounced in those suffering from asthma and cystic fibrosis. Spores of aspergillus are commonly found in the soil and are also present in the sputum of healthy people.

In ABPA, the airways become inflamed often leading to constriction, which makes it very difficult for the patient to breathe. This condition is often difficult to diagnose if the person does not know that he/she has asthma because the symptoms closely resemble those of eosinphilic pneumonia, a condition in which a specific type of white blood cells collect in the lungs.

The diagnosis of ABPA requires several different types of medical equipment and tests. Chest X-rays and CT scans are commonly used and blood tests help determine if there are raised levels of lgE or eosinophils in the blood.  The symptoms of this condition consist of a wheezing cough, shortness of breath and an inability to exercise or engage in physical activity for any length of time. The patient also coughs up brown colored sputum, which is very similar to one of the symptoms of bronchitis. Recurrent infections are also symptomatic of this condition. Since ABPA does not respond well to antibiotics as the method of treatment, doctors who do prescribe the medication often start out with a diagnosis of bronchitis or pneumonia and then change their minds based on the evidence.

The problem with using a blood test alone to help determine if a patient is suffering from ABPA is that in the majority of cases the blood test does not detect the presence of eosinophils or a raised lgE level. The levels do have to be really high in order for them to be found in a blood test and by this time the patient is really suffering.  A chest X-ray taken to determine whether the diagnosis is that of ABPA has to be closely examined to determine if there is any thickening of the bronchial walls, shadows in the peripheral areas or if there are signs of a collapsed lung.

The treatment for ABPA is usually corticosteroids. The purpose is to suppress the reaction that the immune system has to the aspergillus and to control the spasms of the bronchial tubes. In an acute attack, the recommended dosage may be as high as 30 to 45 mg per day, but in general the patient has to take only 5 to 10 mg per day as a preventative measure. Once you are diagnosed as having ABPA, you can be prepared to have to take this medication on a daily basis in order to control the asthmatic reaction.


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