Allergic bronchopulmonary aspergillosis.
نویسندگان
چکیده
There remains a lack of agreement on diagnostic criteria and approaches to treatment of patients with allergic bronchopulmonary aspergillosis (ABPA). The results of a survey of American Academy of Allergy, Asthma, & Immunology members regarding these 2 issues are presented and compared for concordance with published recommendations. The literature was reviewed for pertinent reports, and an electronic survey was conducted of American Academy of Allergy, Asthma, & Immunology members and fellows regarding diagnostic criteria, numbers of patients evaluated for ABPA, and treatment approaches. From 508 respondents to the survey sent to 5155 US physicians in the American Academy of Allergy, Asthma, & Immunology database of members and fellows, 245 health professionals (48%) had treated at least 1 patient with ABPA in the previous year. For the diagnosis of ABPA, there was a difference in the threshold concentration of total serum IgE because 44.9% used ≥417 kU/L, whereas 42.0% used ≥1000 kU/L. Analysis of these findings suggests that ABPA might be underdiagnosed. With regard to pharmacotherapy, oral steroids were recommended for 97.1% of patients and oral steroids plus inhaled corticosteroids plus antifungal agent were used with 41.2% of patients. The armamentarium for treatment of ABPA includes oral corticosteroids as the initial treatment with inhaled corticosteroids used for management of persistent asthma. Azoles remain adjunctive. Published experience with omalizumab has been limited.
منابع مشابه
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Allergic bronchopulmonary aspergillosis is a lung disease characterized by an immune response to several antigens of Aspergillus species. Corticosteroids are the treatment of choice in the acute phase, although some studies have shown the efficacy of itraconazole. We describe the case of a favorable, prolonged therapeutic response to voriconazole in a patient with allergic bronchopulmonary aspe...
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REFERENCES 1 Stevens DA, Moss RB, Kurup VP, et al. Allergic bronchopulmonary aspergillosis in cystic fibrosis – state of the art: Cystic Fibrosis Foundation Consensus Conference. Clin Infect Dis 2003; 37: Suppl. 3, S225–S264. 2 Skowronski E, Fitzgerald DA. Life-threatening allergic bronchopulmonary aspergillosis in a well child with cystic fibrosis. Med J Aust 2005; 182: 482–483. 3 Skov M, Main...
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ورودعنوان ژورنال:
- Allergy proceedings : the official journal of regional and state allergy societies
دوره 11 4 شماره
صفحات -
تاریخ انتشار 1983