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What Causes Allergic Broncho Pulmonary Aspergillosis?

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Posted on Tue, 18 Mar 2014
Question: If a person has bronchiectasis and there is a suspicion that it may be related to mold in his home (or possibly GERD), would the patient most lkely have elevated antibodies to aspergillus upon allergy testing? He did not. I am wondering if one can have Aspergillu-induced bronchiectasis if the the patient does not have elevated antibodies to that mold.
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Answered by Dr. Gyanshankar Mishra (59 minutes later)
Brief Answer: It could be ABPA. Detailed Answer: Hi, Thanks for posting the query on HCM. After going through your query, I would like to comment the following: 1. Considering the history of asthma with bronchiectasis there is always a possibility of ABPA or Allergic broncho pulmonary aspergillosis. 2. ABPA is recognised as an allergy manifestation of fungus/ mold viz. aspergillus. 3. GERD is an inde;pendent risk factor for asthma as well as long standing cough. 4. Yes, a patient may still have ABPA in absence of elevated antibodies to aspergillus. There are other criteria also for diagnosis of ABPA. Check for total serum IgE levels, and specific IgE and IgA levels for aspergillus. Get sputum checked for fungus. All of these are pointers to diagnosis of ABPA. I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries. Regards Dr. Gyanshankar Mishra MBBS MD DNB Consultant Pulmonologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Gyanshankar Mishra

Pulmonologist

Practicing since :2003

Answered : 600 Questions

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What Causes Allergic Broncho Pulmonary Aspergillosis?

Brief Answer: It could be ABPA. Detailed Answer: Hi, Thanks for posting the query on HCM. After going through your query, I would like to comment the following: 1. Considering the history of asthma with bronchiectasis there is always a possibility of ABPA or Allergic broncho pulmonary aspergillosis. 2. ABPA is recognised as an allergy manifestation of fungus/ mold viz. aspergillus. 3. GERD is an inde;pendent risk factor for asthma as well as long standing cough. 4. Yes, a patient may still have ABPA in absence of elevated antibodies to aspergillus. There are other criteria also for diagnosis of ABPA. Check for total serum IgE levels, and specific IgE and IgA levels for aspergillus. Get sputum checked for fungus. All of these are pointers to diagnosis of ABPA. I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries. Regards Dr. Gyanshankar Mishra MBBS MD DNB Consultant Pulmonologist