Overview
Allergic bronchopulmonary aspergillosis (ABPA) is an overreaction of the immune system in response to exposure to fungal allergens present in the airways or sinuses.
Symptoms
Typically, ABPA is predominantly associated with poorly controlled asthma, but symptoms can also include:
- Excessive mucus production
- Chronic cough
- Haemoptysis
- Bronchiectasis
- Fever
- Weight loss
- Night Sweats
Causes
Although inhaled fungus is normally removed from the airways of healthy people by defence mechanisms, inadequate clearance in patients with conditions like asthma and cystic fibrosis (CF) allows the fungus to develop and produce long branching strands called hyphae. In response to this, the body’s immune system makes antibodies (IgE) to fight the perceived threat. The production of the antibodies leads to a cascade of reactions from the immune system that are responsible for the development of symptoms.
Diagnosis
Diagnosis requires a combination of:
- Presence of a predisposing condition: Asthma or cystic fibrosis
- Positive Aspergillus skin prick test
- Blood tests
- Chest X-Ray and/or CT scan
Treatment
- Oral steroids (e.g. prednisolone) to reduce inflammation and lung damage.
- Antifungal medication, such as Itraconazole.
Prognosis
There is no complete cure for ABPA, but the management of inflammation and scarring using itraconazole and steroids usually succeeds in stabilising the symptoms for many years.
ABPA can very rarely progress to CPA.
Patient Story
In this video, created for World Aspergillosis Day 2022, Alison, who lives with allergic bronchopulmonary aspergillosis (ABPA), discusses diagnosis, the impacts of the disease and how she manages it daily.