Tuberculosis and Respiratory Diseases

  • 제78권2호
  • /
  • Pages.133-136
  • /
  • 2015
  • /
  • 1738-3536(pISSN)
  • /
  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
권호 표지
DOI QR코드

DOI QR Code

Allergic Bronchopulmonary Aspergillosis Presenting as Recurrent Mass-like Consolidation

  • Choe, Yeong Hun (Department of Internal Medicine, Chonbuk National University Medical School)
  • 투고 : 2014.11.14
  • 심사 : 2015.01.20
  • 발행 : 2015.02.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitive disease showing various radiographic and clinical manifestations. Its clinical course has not been fully understood. Here I describe a case of a 23-year-old immunocompetent man with frequently relapsing ABPA. He was asthmatic. He visited our hospital because of a chronic cough. Laboratory examination showed eosinophilia with increased total and Aspergillus-specific IgE as well as positive skin reaction to Aspergillus fumigatus. Radiologic feature was a dense consolidation. Histology showed organizing pneumonia with eosinophilic infiltration. On the diagnosis of ABPA, he was treated with systemic steroid and itraconazole. Although treatment response was excellent, he suffered from recurrent ABPA three times thereafter in the form of fleeting mass-like consolidation.

키워드

참고문헌

  1. Greenberger PA. Allergic bronchopulmonary aspergillosis. J Allergy Clin Immunol 2002;110:685-92. https://doi.org/10.1067/mai.2002.130179
  2. Bains SN, Judson MA. Allergic bronchopulmonary aspergillosis. Clin Chest Med 2012;33:265-81. https://doi.org/10.1016/j.ccm.2012.02.003
  3. Agarwal R, Gupta D, Aggarwal AN, Behera D, Jindal SK. Allergic bronchopulmonary aspergillosis: lessons from 126 patients attending a chest clinic in north India. Chest 2006;130:442-8. https://doi.org/10.1378/chest.130.2.442
  4. Agarwal R, Garg M, Aggarwal AN, Saikia B, Gupta D, Chakrabarti A. Serologic allergic bronchopulmonary aspergillosis (ABPA-S): long-term outcomes. Respir Med 2012;106:942-7. https://doi.org/10.1016/j.rmed.2012.03.001
  5. Agarwal R. Allergic bronchopulmonary aspergillosis. Chest 2009;135:805-26. https://doi.org/10.1378/chest.08-2586
  6. Agarwal R, Gupta D, Aggarwal AN, Saxena AK, Chakrabarti A, Jindal SK. Clinical significance of hyperattenuating mucoid impaction in allergic bronchopulmonary aspergillosis: an analysis of 155 patients. Chest 2007;132:1183-90. https://doi.org/10.1378/chest.07-0808
  7. Kiely JL, Spense L, Henry M, Hurley MF, Kelleher N, Bredin CP. Chest radiographic staging in allergic bronchopulmonary aspergillosis: relationship with immunological findings. Eur Respir J 1998;12:453-6. https://doi.org/10.1183/09031936.98.12020453
  8. Patterson R, Greenberger PA, Lee TM, Liotta JL, O'Neill EA, Roberts M, et al. Prolonged evaluation of patients with corticosteroid- dependent asthma stage of allergic bronchopulmonary aspergillosis. J Allergy Clin Immunol 1987;80:663-8. https://doi.org/10.1016/0091-6749(87)90285-5
  9. Miller PW, Hamosh A, Macek M Jr, Greenberger PA, MacLean J, Walden SM, et al. Cystic fibrosis transmembrane conductance regulator (CFTR ) gene mutations in allergic bronchopulmonary aspergillosis. Am J Hum Genet 1996;59:45-51.
  10. Rosa-Rosa L, Zimmermann N, Bernstein JA, Rothenberg ME, Khurana Hershey GK. The R576 IL-4 receptor alpha allele correlates with asthma severity. J Allergy Clin Immunol 1999;104:1008-14. https://doi.org/10.1016/S0091-6749(99)70082-5
  11. Saxena S, Madan T, Shah A, Muralidhar K, Sarma PU. Association of polymorphisms in the collagen region of SP-A2 with increased levels of total IgE antibodies and eosinophilia in patients with allergic bronchopulmonary aspergillosis. J Allergy Clin Immunol 2003;111:1001-7. https://doi.org/10.1067/mai.2003.1395
  12. Carvalho A, Pasqualotto AC, Pitzurra L, Romani L, Denning DW, Rodrigues F. Polymorphisms in toll-like receptor genes and susceptibility to pulmonary aspergillosis. J Infect Dis 2008;197:618-21. https://doi.org/10.1086/526500
  13. Kauffman HF, Beaumont F, de Monchy JG, Sluiter HJ, de Vries K. Immunologic studies in bronchoalveolar fluid in a patient with allergic bronchopulmonary aspergillosis. J Allergy Clin Immunol 1984;74:835-40. https://doi.org/10.1016/0091-6749(84)90187-8
  14. Persson CG, Erjefalt JS, Erjefalt I, Korsgren MC, Nilsson MC, Sundler F. Epithelial shedding: restitution as a causative process in airway inflammation. Clin Exp Allergy 1996;26:746-55. https://doi.org/10.1111/j.1365-2222.1996.tb00604.x