29th July 2023

Allergic bronchopulmonary aspergillosis (ABPA)

ABPA occurs most often in individuals with underlying asthma or cystic fibrosis due to a hypersensitivity reaction to inhaling Aspergillus spores.

The clinical presentation is similar to an acute exacerbation of asthma or a severe allergic reaction – characterised by wheezing, cough and shortness of breath.

It is associated with bronchiectasis, which is a potential chest X-ray finding. Characteristically, patients will demonstrate marked eosinophilia on blood tests. Radioallergosorbent (RAST) tests and Aspergillus-specific IgE serum tests can also be done to confirm the diagnosis.

First line treatment is with oral corticosteroids, with itraconazole used as the second line for cases which fail to respond to initial treatment.