this lecture( Allergic bronchopulmonary aspergillosis), has been presented by Dr.Anas azarmouh / azreig horpital. , that was in the event of Global asthma day 2018.
A detailed description of sarcoidosis, pulmonary in specific but also covering the other systems. a rare entity in india or a better way to say, often an overlooked disease.
The global Type 2 Diabetes (T2D) market is estimated to be $31.3 billion in 2014 and is expected to grow at a CAGR of mid-range single digit from 2015 to 2021 to reach $46.7 billion by 2021
this lecture( Allergic bronchopulmonary aspergillosis), has been presented by Dr.Anas azarmouh / azreig horpital. , that was in the event of Global asthma day 2018.
A detailed description of sarcoidosis, pulmonary in specific but also covering the other systems. a rare entity in india or a better way to say, often an overlooked disease.
The global Type 2 Diabetes (T2D) market is estimated to be $31.3 billion in 2014 and is expected to grow at a CAGR of mid-range single digit from 2015 to 2021 to reach $46.7 billion by 2021
51 Beginner Cycling Tips From Experienced CyclistsCycling Tips HQ
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Social media is not a replacement of previous forms of communication. Keep doing those things you used to do, social media is just another tool. The strength of social media is that it can empower your audiences to participate in your communication and brand development….hopefully in a good way.
NAHO 2011 Speaker Series, Ottawa, February 23, 2011
Pierre S. Haddad PhD
Department of Pharmacology Université de Montréal
This talk is dedicated to the memory of Elders
Sam Awashish, René Coon Come,
Smally Petawabano and Sally Matthews
These lecture notes were prepared by Dr. Hamdi Turkey- Pulmonologist- Department of internal medicine - Taiz university
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Aspergillosis Patients Support Outreach Meeting London June 2011 - David DenningGraham Atherton
Talk given to the Aspergillosis Patients Outreach Meeting in London entitled "ABPA and SAFS" by National Aspergillosis Centre Director Professor David Denning
Management of Chronic Pulmonary Aspergillosis and IgE for the LaypersonGraham Atherton
Professor Denning summarises how we manage CPA at the National Aspergillosis Centre, what we have learned, what we are still learning.
Graham Atherton describes IgE and how it affects Aspergillosis
The In Vivo Effects of Asplenum Bulbiferum Ethanolic Leaf Extracts on Four Co...ijtsrd
Lung diseases have been a worldwide health problem, with high endemicity in developing countries. Bronchopneumonia remains the main disease of the lung. Despite advances in modern medicines, there is no effective drug available that stimulate lung function, offer protection to the lung from damage or help to regenerate pulmonary cells destroyed by disseminated bacteria. There is an urgent need for effective drugs to replace supplement those in current use. This study was embacked upon to evaluate the effect of Asplenium bulbiferum leaf extracts on nosily infected mice with streptococcus pneumoniae isolate of suspension containing 5x106 cells ul. Streptococcus pneumoniae was obtained from human specimen, identified through cultural, morphological and biochemical examination, in addition, polymerase chain reaction PCR technique was performed using universal primers to support the identification process. The antibacterial activity was carried out using agar well diffusion technique. Tube dilution technique was used to determine the minimum Inhibition Concentration MIC and Minimum Bactericidal Concentration MBC using double fold serial dilution at concentrations of 400mg ml to 25mg ml. The effect of the leaf extract was evaluated by treating mus musculus mice WBC count 4.5x103 with sub MIC of A. bulbiferum extracts after nosily infected with S. pneumoniae and appearance of disease septum with 11.3x103 WBC count after 5days from infection. The photochemical analysis revealed the presence of alkaloids phenolics, tannins, saponins, flavonoids, steroids and glycosides. The ethanolic extract exhibited more activity than the aqueous extract against S. aureus most followed by S. pneumoniae, H. influenza and K. pneumoniae was the least. After treating the infected mice with the plant extract and after 6 days from infection, the WBC count reduced to 5.1x103 l which is normal range and the mice were healthy with good physiological behaviour. The infected mice and untreated with extracts, the WBC and other immunological parameters remain high even after 16 days from infection. The study showed that Asplenium bulbiferum possessed antibacterial properties and should serve as alternative therapy for ameliorating lung infections. Eze, H. C | Ajogwu, T. M | Ozor C. N | Gloria, C. I | Soludo, O. C "The In-Vivo Effects of Asplenum Bulbiferum Ethanolic Leaf Extracts on Four Common Bacteria Associated with Lung Diseases" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-6 , October 2021, URL: https://www.ijtsrd.com/papers/ijtsrd47622.pdf Paper URL : https://www.ijtsrd.com/biological-science/microbiology/47622/the-invivo-effects-of-asplenum-bulbiferum-ethanolic-leaf-extracts-on-four-common-bacteria-associated-with-lung-diseases/eze-h-c
Pertussis : Highly contagious respiratory infection caused by Bordetella pertussis
Outbreaks first described in 16th century
Bordetella pertussis isolated in 1906
Estimated >300,000 deaths annually worldwide
Before the availability of pertussis vaccine in the 1940s, public health experts reported more than 200,000 cases of pertussis annually.
Since widespread use of the vaccine began, incidence has decreased more than 75% compared with the pre-vaccine era.
In 2012, the last peak year, CDC reported 48,277 cases of pertussis.
Extremely contagious-attack rate 100%
Immunity is never complete
Protection begins to wane in 3-5 yrs after vaccination
IPA was first described in 1953. Due to
widespread use of chemotherapy and immunosuppressive agents, its incidence has increased
over the past two decades. Of all autopsies
performed between 1978 and 1992, the rate of
invasive mycoses increased from 0.4% to 3.1%, as
documented. IPA increased
from 17% to 60% of all mycoses found on autopsy
over the course of the study. The mortality rate of
IPA exceeds 50% in neutropenic patients and
reaches 90% in haematopoietic stem-cell transplantation (HSCT) recipients
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Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
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Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
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This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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2. Allergic Bronchopulmonary Aspergillosis: An Unusual Complication of
Bronchial Asthma
Pages with reference to book, From 329 To 331
S. Fayyaz Hussain, Javaid A. Khan ( Department of Medicine, The Aga Khan University Hospital, Karachi. ) M.
Ata Khan ( Department of Medicine, The Aga Khan University Hospital. Karachi. )
3. Case 1.
A 19 year old male, asthmatic from childhood. developed fever, cough,
hemoptysis and pulmonary infiltrate in 1987. He was treated for TB for nine
months. In 1992, he again presented with fever, anorexia, cough, hemoptysis
S. Fayyaz Hussain, Javaid A. Khan ( Department of Medicine, The Aga Khan University Hospital,
Karachi. ) M. Ata Khan ( Department of Medicine, The Aga Khan University Hospital. Karachi. )
4. Sputum was negative for AFB but on clinical
suspicion, he was restarted on quadruple anti-TB
therapy in adequate doses. In addition, he
continued to receive bronchodilators, inhaled
steroids and intermittent courses of oral
prednisolone.
Six months later, while still on anti-TB drugs, he
developed recurrence of symptoms with right
pleuritic chest pain, fever, cough, wheeze and
hemoptysis. Repeat chest x-ray showed infiltrates
in right lung (Figure ib).
S. Fayyaz Hussain, Javaid A. Khan ( Department of Medicine, The Aga Khan University Hospital,
Karachi. ) M. Ata Khan ( Department of Medicine, The Aga Khan University Hospital. Karachi. )
5. S. Fayyaz Hussain, Javaid A. Khan ( Department of Medicine, The Aga Khan University Hospital,
Karachi. ) M. Ata Khan ( Department of Medicine, The Aga Khan University Hospital. Karachi. )
6. Sputum for AFB was negative. He had eosinophilia
of 12% (WBC count 12600/dI) and 2grossly
elevated serum IgE (>1000 iu/ml). Aspergillus
antibodies were negative.
Diagnosis of ABPA was made and prednisolone 30
mg daily was started. This resulted in rapid
resolution of clinical and radiological features.
Patient remains well on maintenance prednisolone
at a dose of 7.5 mg daily.
S. Fayyaz Hussain, Javaid A. Khan ( Department of Medicine, The Aga Khan University Hospital,
Karachi. ) M. Ata Khan ( Department of Medicine, The Aga Khan University Hospital. Karachi. )
7. CASE 2:
A 24 year old male, asthmatic for four years,
presented with high grade fever, cough with
purulent sputum and right sided chest pain. He had
two similar episodes during the last one year.
Bilateral widespread rhonchi and crepitation were
found on chest examination.
Chest x-ray showed bilateral interstitial infiltrates
and bronchiectatic changes.
White cell count was 12700/dl with 33%
eosinophils. Sputum for AFB were negative.
Serum IgE was elevated above 1700 lU/mi.
S. Fayyaz Hussain, Javaid A. Khan ( Department of Medicine, The Aga Khan University Hospital,
Karachi. ) M. Ata Khan ( Department of Medicine, The Aga Khan University Hospital. Karachi. )
8. S. Fayyaz Hussain, Javaid A. Khan ( Department of Medicine, The Aga Khan University Hospital,
Karachi. ) M. Ata Khan ( Department of Medicine, The Aga Khan University Hospital. Karachi. )
Diagnosis of ABPA was made and prednisolone 1mg/kg/day was
started. Patient improved
9. Allergic Bronchopulmonary Aspergillosis: An Unusual Complication of
Bronchial Asthma
Pages with reference to book, From 329 To 331
S. Fayyaz Hussain, Javaid A. Khan ( Department of Medicine, The Aga Khan University Hospital, Karachi. ) M.
Ata Khan ( Department of Medicine, The Aga Khan University Hospital. Karachi. )
The clinical features of ABPA (cough, fever, hemoptysis and
lung infiltrates) are usually mistaken for pulmonary tuberculosis
10. CHEST. 2006;130(2):442-448. DOI:10.1378/CHEST.130.2.442
ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS*:LESSONS FROM 126
PATIENTS ATTENDING A CHEST CLINIC IN NORTH INDIA.
RITESH AGARWAL, MD, DM, FCCP; DHEERAJ GUPTA, MD, DM, FCCP; ASHUTOSH N. AGGARWAL, MD, DM;
DIGAMBER BEHERA, MD, FCCP; SURINDER K. JINDAL, MD, FCCP
Five hundred sixty-four patients were screened using an Aspergillus skin test; 223 patients (39.5%)
were found to be positive, and ABPA was diagnosed in 126 patients (27.2%). There were 34 patients
(27%) with ABPA-S, 42 patients with ABPA-CB, and 50 patients with ABPA-CB-ORF. Fifty-nine patients
(46.8%) had received antitubercular therapy in the past. The vast majority of patients had bronchiectasis
at presentation to our hospital. High-attenuation mucous impaction was noted in 21 patients (16.7%).
There was no significant difference between the stages of ABPA and the duration of illness, the severity
of asthma, and the serologic findings (ie, absolute eosinophil count, IgE levels [total] and IgE levels
[for Aspergillus fumigatus]).
Conclusions: There is a high prevalence of ABPA in asthmatic patients presenting at our hospital. The
disease entity is still underrecognized in India; the vast majority of patients
have bronchiectasis at presentation, and almost half are initially
misdiagnosed as having pulmonary tuberculosis. There is a need to redefine the
definitions of ABPA and the optimal dose/duration of glucocorticoid therapy. This study reinforces the
need for the routine screening of asthmatic patients with an Aspergillus skin test.
Fifty-nine patients (46.8%) had received antitubercular therapy in the past
11. Respiratory Medicine CME
Volume 4, Issue 4, Pages 149-200 (2011)
Case Report
Allergic bronchopulmonary aspergillosis presenting with cough variant
asthma with spontaneous remission
Hirofumi Matsuoka, Towa Uzu, Midori Koyama, Yasuko Koma, Kensuke
Fukumitsu, Yoshitaka Kasai, Daiki Masuya, Harukazu Yoshimatsu, Yujiro Suzuki
A 60-year-old woman presented with a dry cough without dyspnea or wheezing.
Chest CT showed an image of mucoid impactions, which were identified as
mucoid impactions by bronchofiberscopy.
12. Fig. 1. Chest radiograph showing bilateral
infiltrates.
Fig. 2.
a: Chest CT image during the
acute phase shows an image of
mucoid impactions in the right
middle lung lobe and the left
lingular bronchus.
b: Chest CT image during the
remission stage shows
bronchiectasis in the lingula of the
left lung. The image of m...
Fig. 3. Bronchofiberscopy findings. Mucoid
impaction in the right middle lung lobe bronchus
Respiratory Medicine CME, Volume 4, Issue 4, 2011, 175–177
A 60-year-old woman presented with a dry cough without dyspnea or wheezing.
13.
14.
15. Natural history of aspergilllus infection in Indian population is
a course of anti –TB, bronchial asthma with frequent steroid intake
16. 17. D´Urzo,Mclvor A.R. Allergic bronchopulmonary aspergillosis in asthma.
Can Fam Physician. 2000 Apr; 46: 882–884.
18. Shah A, Panchal N, Agarwal AK. Concomitant allergic bronchopulmonary
aspergillosis and allergic aspergillus sinusitis: a review of an uncommon
association. Clin Exp Allergy 2001;31:1896–1905. [CrossRef] [Medline]
19. Agarwal R, Srinivas R, Jindal SK. Allergic bronchopulmonary aspergillosis
complicating chronic obstructive pulmonary disease. Mycoses 2007;51:83–85.
20. Boz AB, Celmeli F, Arslan AG, Cilli A, Ogus C, Ozdemir T. A case of allergic
bronchopulmonary aspergillosis following active pulmonary
tuberculosis. Pediatr Pulmonol 2009;44:86–89. [CrossRef] [Medline]
21. Judson MA. Allergic bronchopulmonary aspergillosis after infliximab therapy
for sarcoidosis: a potential mechanism related to T-helper cytokine
balance. Chest 2009;135:1358–1359. [CrossRef] [Medline]
39. Agarwal R, Singh N, Gupta D. Pulmonary hypertension as a presenting
manifestation of allergic bronchopulmonary aspergillosis. Indian J Chest Dis Allied
Sci 2009;51:37–40. [Medline]
Uncommon associations of allergic bronchpulmonary aspergillosis
17. Sources of Infection?
Aspergillus species are found in :
Soil, Compost and decaying vegetation
Air; spores may be inhaled
Water / storage tanks in hospitals etc
Food
Fire proofing materials
Bedding, pillows
Ventilation and air conditioning systems
Computer fans
Aspergillus
spores
18. The life cycle of Aspergillus
Spores inhaled Germination
Mass of hyphae
(plateau phase)
Hyphal elongation
and branching
19. Patients whose immune system is already weakened are most susceptible.
Those most at risk include some cancer and leukaemia patients, those
on chemotherapy and transplant patients.
Immune malfunction
Frequencyofaspergillosis
Immune hyper-reactivity
Frequencyofaspergillosis
Acute invasive
aspergillosis
Aspergilloma
Allergic aspergillosis
Allergic sinusitis
Normal
immune
function
Relative risk of Aspergillus infection
21. Invasive pulmonary aspergillosis (IPA) is a severe
disease, and can be found not only in severely
immunocompromised patients, but also in critically
ill patients and those with chronic obstructive
pulmonary disease (COPD).
Aspergilloma is a fungus ball that develops in a pre-
existing cavity within the lung parenchyma
ABPA is a hypersensitivity manifestation in the lungs
that almost always affects patients with asthma or
cystic fibrosis .
22. allergic pulmonary disorder caused by
hypersensitivity to Aspergillus fumigatus 1
Occurs in asthma or cystic fibrosis2
result of immune response to Aspergillus
colonization of airway and poor clearance
of mucus secretions
subsequent bronchiectasis, pulmonary
fibrosis, and compromise of pulmonary
function
first described by Hinson et al in 1952 in UK
1.CHEST 2009; 135:805–826.
2. Middleton’s Allergy, Principle&Practice 7th edition.
Allergic Bronchopulmonary Aspergillosis
23. Clinical feature
Symptom
◦ occasionally be asymptomatic
◦ low-grade fever, wheezing, bronchial hyperreactivity,
◦ hemoptysis, or productive cough
◦ Expectoration of brownish black mucus plugs (31 to
69%)
Physical examination
◦ normal or polyphonic wheeze
◦ Clubbing (16% )
◦ coarse crackles (15%)
◦ localized findings of consolidation and atelectasis
during exacerbation
◦ Complications eg. pulmonary HT and/or respiratory
failure
CHEST 2009; 135:805–826.
24. Laboratory Findings
Aspergillus Skin Test
◦ Type I and III reaction
◦ SPT and intradermal test (if SPT negative )
Total Serum IgE Levels
◦ most useful test for diagnosis and follow-up
of ABPA
◦ Exclude ABPA ( if not steroid used)
◦ 35 to 50% decrease : criteria for remission
◦ Doubling of baseline IgE levels : relapse of
ABPA
CHEST 2009; 135:805–826
25. Laboratory Findings
Serum IgE and IgG Antibodies Specific
to A. fumigatus
◦ Hallmark of ABPA
◦ cutoff value of IgG/IgE > twice pooled serum
samples
Serum Precipitins Against A. fumigatus
◦ Precipitating IgG Ab using double gel
diffusion technique
Peripheral Eosinophilia
◦ AEC >1,000 cells/μL (major criteria)
◦ low eosinophil count not exclude ABPA
CHEST 2009; 135:805–826
26. Laboratory Findings
Sputum Cultures for A fumigatus
◦ supportive ,but not diagnostic
◦ rarely perform for diagnosis of ABPA
Pulmonary Function Tests
◦ Categorize severity, no diagnostic value
◦ usual finding is obstructive defect
Role of Specific Aspergillus Antigens
◦ Further studies are required
CHEST 2009; 135:805–826
27. Radiologic Investigations
Chest radiographic findings
Transient changes
◦ Patchy areas of consolidation
◦ Radiologic infiltrates: toothpaste and gloved finger
shadows due to mucoid impaction in dilated bronchi
◦ Collapse: lobar or segmental
◦ Perihilar infiltrates may simulate adenopathy
Permanent changes
◦ Parallel-line shadows representing bronchial widening
◦ Ring-shadows 1–2 cm in diameter representing dilated
bronchi en face
◦ Pulmonary fibrosis: fibrotic scarred upper lobes with
cavitation
CHEST 2009; 135:805–826
28. Fig. Chest X-Ray of ABPA patient with right middle zone infiltrate
29. Fig. Chest X-Ray of ABPA patient with Consolidation and Finger like
shadow
30.
31. Chest x-ray in a patient with ABPA:
ring shadows (long arrows) represent bronchiectatic airways
seen in cross-section; tram lines (short arrow) seen longitudinally
37. Bronchiectasis : cylindrical when bronchus taper and is 1.5 to >3 times caliber
of diameter of adjacent artery
J Allergy Clin Immunol 2002;110:685-92.
39. Primary criteria:
Asthma
Peripheral blood eosinophilia
Positive skin test for aspergillus
Precipitating antibodies(IgG) in serum
Serums Af spesific IgG and IgE
IgE elevation (>1000mL)
Pulmonary infiltrations
Central bronchiectasis
Secondary criteria:
Positive sputum culture for aspergillus
History of brown mucus plug expectoration
Positive type III(Arthus) reaction for aspergillosis
ABPA Diagnostic Criteria
Soubani AO.Chest 2002;121:1988-1999
Lazarus AA. Dis Mon 2008;54:547-564
Agarwal R. Chest 2009;135:805-826
40. ABPA-Central Bronchiectasis (ABPA-SB)
Asthma
Central bronchiectasis
Immediate cutaneous hyperreactivity to Af
antigens
Elevated IgE ( >417 U/L or 1000ng/ml)
Raised A fumigatus specific IgE and IgG
ABPA-Serological (ABPA-S)
Asthma
Immediate cutaneous hyperreactivity to Af
antigens
Elevated IgE ( >417 U/L or 1000ng/ml)
Raised Af specific IgE and IgG
Transient pulmonary infiltrates on chest
radiograph
Rosenberg M.Annals of Intern Med 1977;86:405-414
Greenberger PA. JACI 2002;110:685-692
Agarwal R. Chest 2009;135:805-826
Rosenberg-Patterson criteria
41. Diagnosis and Diagnostic
Criteria
(Minimal diagnostic criteria for ABPA)
Minimal ABPA-CB
Asthma
Immediate cutaneous
hyperreactivity to
Aspergillus antigens
Elevated IgE
Raised A fumigatus-
specific IgG and IgE
Central bronchiectasis
Minimal ABPA-S
Asthma
Immediate cutaneous
hyperreactivity to
Aspergillus antigens
Elevated IgE
Raised A fumigatus-
specific IgG and IgE
Transient pulmonary
infiltrates on chest
radiograph
CHEST 2009; 135:805–826
43. All patients with bronchial asthma
Positive
Chest radiograph, HRCT
IgG/IgE spesific to Af
Eosinophil count
Precipitins to Af
Spirometry
Aspergillus skin test
IgE levels Follow-up with repeat skin test
Yes
>1000 IU/mL
Negative
500-1000 IU/mL
More than two-fold compared AH
IgE / yıl ile izlemIgG/IgE spesific to Af
No
Follow-up with IgE levels every 6 wk
If increasing or >1000 IU/mL
Treatment for ABPA
<500 IU/mL
ABPA
Diagnostic Algoritm
Agarwal R. Chest 2009;135:805-826
44. Management
Systemic Glucocorticoid Therapy
◦ treatment of choice for ABPA
◦ Suppress immune hyperfunction & antiinflammatory
◦ Long term therapy not recommended
Regimen 1 (relapse /steroid dependence 45%)
◦ Prednisolone, 0.5 mg/kg/d, for 1–2 wk, then on AD for
6–8 wk. Then taper by 5–10 mg every 2 wk and
discontinue
◦ Repeat total serum IgE and chest radiograph in 6 to 8
wk
Regimen 2 (steroid dependence 13.5%)
◦ Prednisolone, 0.75 mg/kg/d, for 6 wk, 0.5 mg/kg for 6
wk, then tapered by 5 mg every 6 wk to continue for
total duration of at least 6 to 12 mo.
◦ total IgE levels are repeated every 6 to 8 wk for 1 yr
to determine baseline IgE
CHEST 2009; 135:805–826
45. Management
Follow-up and monitoring
Hx and PE , chest radiograph, and total IgE every 6 wk
to demonstrate decline in IgE levels and clearing of
chest radiograph
35% decline in IgE level signifies satisfactory response
to therapy
Doubling of baseline IgE : silent ABPA exacerbation
If cannot be tapered off prednisolone, disease has
evolved into stage IV. Management should be
attempted with alternate-day prednisone with least
possible dose
Monitor for adverse effects (eg, HT, secondary DM)
Prophylaxis for osteoporosis: oral calcium and
bisphosphonates
CHEST 2009; 135:805–826
46. Management
Oral itraconazole
◦ Dose: 200 mg bid for 16 wk then once a day
for 16 wk
◦ Indication: First relapse of ABPA or
glucocorticoid-dependent ABPA
◦ Follow-up and monitoring
◦ Monitor for adverse effects (eg, nausea,
vomiting, diarrhea,and elevated liver
enzymes)
◦ Monitor for drug–drug interactions
◦ Monitor clinical response based on clinical
course,radiography, and total IgE levels
CHEST 2009; 135:805–826
47. Management
Inhaled Corticosteroids
◦ DBPC multicenter (32 pts.) no superiority
over placebo
◦ Use only for control of asthma once oral
prednisolone dose is reduced to 10 mg/d
Other Therapies
◦ other antifungal agents (e.g. amphotericin B,
ketoconazole, clitromazole, nystatin and
natamycin) severe adverse effects and no
significant beneficial effects
◦ Omalizumab (case report)
CHEST 2009; 135:805–826
48. Treatment of Allergic Bronchopulmonary Aspergillosis
(ABPA) in CF With Anti-IgE Antibody (Omalizumab)
Adaobi Kanu. Pediatr Pulmonol. 2008; 43:1249–1251
Successful treatment of allergic bronchopulmonary
aspergillosis with recombinant anti-IgE antibody
Cornelis K van der Ent . Thorax 2007;62;276-277
Steroid-Sparing Effect of Omalizumab for Allergic
Bronchopulmonary Aspergillosis and Cystic Fibrosis
Jacquelyn M. Zirbes . Pediatr Pulmonol. 2008; 43:607–610
Omalizumab (ABPA)
49. TAKE HOME MESSAGES
Allergic Bronchopulmonary Aspergillosis (ABPA),
an immune mediated disease, is an unusual
complication of bronchial asthma which can result
in bronchiectasis, pulmonary fibrosis, respiratory
failure and death.
The clinical features of ABPA (cough, fever,
hemoptysis and lung infiltrates) are usually
mistaken for pulmonary tuberculosis (TB).
Early diagnosis is important so that with proper
therapy permanent lung damage can be prevented.