Allergic Bronchopulmonary Aspergillosis Health Article

Definition

Allergic bronchopulmonary aspergillosis, or ABPA, is one of four major types of infections in humans caused by Aspergillus fungi. ABPA is a hypersensitivity reaction that occurs in asthma patients who are allergic to this specific fungus.

Description

ABPA is an allergic reaction to a species of Aspergillus called Aspergillus fumigatus. It is sometimes grouped together with other lung disorders characterized by eosinophilia—an abnormal increase of a certain type of white blood cell in the blood—under the heading of eosinophilic pneumonia. These disorders are also called hypersensitivity lung diseases.

ABPA appears to be increasing in frequency in the United States, although the reasons for the increase are not clear. The disorder is most likely to occur in adult asthmatics aged 20-40. It affects males and females equally.

Causes and symptoms

ABPA develops when the patient breathes air containing Aspergillus spores. These spores are found worldwide, especially around riverbanks, marshes, bogs, forests, and wherever there is wet or decaying vegetation. They are also found on wet paint, construction materials, and in air conditioning systems. ABPA is a nosocomial infection, which means that a patient can get it in a hospital. When Aspergillus spores reach the bronchi, which are the branches of the windpipe that lead into the lungs, the bronchi react by contracting spasmodically. So the patient has difficulty breathing and usually wheezes or coughs. Many patients with ABPA also run a low-grade fever and lose their appetites.

Complications

Patients with ABPA sometimes cough up large amounts of blood, a condition that is called hemoptysis. They may also develop a serious long-term form of bronchiectasis, the formation of fibrous tissue in the lungs. Bronchiectasis is a chronic bronchial disorder caused by repeated inflammation of the airway, and marked by the abnormal enlargement of, or damage to, the bronchial walls. ABPA sometimes occurs as a complication of cystic fibrosis.