Allergic bronchopulmonay aspergillosis
Primary criteria for allergic bronchopulmonay aspergillosis -
(ARTEPICS)
1) A - asthma
2) R - radiologic evidence of pulmonary disease.
3) T – Test positive for aspergillus fumigatus.
4) E – eosinophilia.
5) P – precipitating antibody to aspergillus fumigatus.
6) I – elevated IgE.
7) C- central bronchiectasis changes.
8) S- elevated aspergillus fumigatus serum specific IgE and IgG.
Secondary criteria for ABPA -
1) Presence of aspergillus fumigatus in sputum.
2) h/o expectoration of mucus plug.
3) Delayed cutaneous reaction to aspergillus fumigatus.
HRCT finding in ABPA-
1) Central bronchiectasis, severe and wide spread.
2) Mucus plugging.
3) High density mucus.
4) Linear or branching centrilobular opacities.
5) Ateletasis.
6) Peripheral consolidation with diffuse ground glass opacity.
7) Mosaic perfusion.
8) Air trapping on expiration.
Disease progression is divided into -
1) Acute phase which leads to
2) Resolution during which pulmonary infiltrates clear and serum IgE declines,resolution is followed by ,
3) Remission when all diagnostic criteria recur evolving,
4) A phase of dependence corticosteroids, finally leads to,
5) Diffuse pulmonary fibrosis.