Allergic bronchopulmonary aspergillosis presenting as lobar or total lung collapse. 2015

Raj Kumar, and Mohammed Noufal Poongadan, and Mandeep Singh
Department of Respiratory Allergy and Applied Immunology, National Centre of Respiratory Allergy, Asthma and Immunology, India. rajkumarvpci@gmail.com.

BACKGROUND Allergic bronchopulmonary aspergillosis (ABPA) is a T-helper cell 2 (Th2) mediated hypersensitive lung disorder in response to Aspergillus that usually affects asthmatic and cystic fibrosis (CF) patients. ABPA rarely presents as lung collapse and such kind of presentation is very rare in non asthmatic patients. We are presenting a series of three cases in which ABPA presented as lobar or total lung collapse. ABPA presenting as opaque hemithorax is a rarity with only a few of them reported in the literature. METHODS the first case described is a 45-year non-smoker with history suggestive of bronchial asthma and on chest radiological examination was found to have opaque right hemithorax. The second case is of 62-year non-smoker non-asthmatic patient who presented to us as left lung collapse. The last case is of middle lobe collapse in asthmatic male. All cases ultimately were proved to be having ABPA and after treatment showed marked clinical and radiological improvement. CONCLUSIONS The present case series highlights the need for aggressive approach in diagnosing this treatable condition in cases presenting as segmental or total lung collapse. The condition has a good prognosis if detected early.

UI MeSH Term Description Entries
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D003550 Cystic Fibrosis An autosomal recessive genetic disease of the EXOCRINE GLANDS. It is caused by mutations in the gene encoding the CYSTIC FIBROSIS TRANSMEMBRANE CONDUCTANCE REGULATOR expressed in several organs including the LUNG, the PANCREAS, the BILIARY SYSTEM, and the SWEAT GLANDS. Cystic fibrosis is characterized by epithelial secretory dysfunction associated with ductal obstruction resulting in AIRWAY OBSTRUCTION; chronic RESPIRATORY INFECTIONS; PANCREATIC INSUFFICIENCY; maldigestion; salt depletion; and HEAT PROSTRATION. Mucoviscidosis,Cystic Fibrosis of Pancreas,Fibrocystic Disease of Pancreas,Pancreatic Cystic Fibrosis,Pulmonary Cystic Fibrosis,Cystic Fibrosis, Pancreatic,Cystic Fibrosis, Pulmonary,Fibrosis, Cystic,Pancreas Fibrocystic Disease,Pancreas Fibrocystic Diseases
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001229 Aspergillosis, Allergic Bronchopulmonary Hypersensitivity reaction (ALLERGIC REACTION) to fungus ASPERGILLUS in an individual with long-standing BRONCHIAL ASTHMA. It is characterized by pulmonary infiltrates, EOSINOPHILIA, elevated serum IMMUNOGLOBULIN E, and skin reactivity to Aspergillus antigen. Allergic Bronchopulmonary Aspergillosis,Allergic Bronchopulmonary Aspergilloses,Aspergilloses, Allergic Bronchopulmonary,Aspergillosis, Bronchopulmonary Allergic,Bronchopulmonary Aspergilloses, Allergic,Bronchopulmonary Aspergillosis, Allergic,Allergic Aspergilloses, Bronchopulmonary,Allergic Aspergillosis, Bronchopulmonary,Aspergilloses, Bronchopulmonary Allergic,Bronchopulmonary Allergic Aspergilloses,Bronchopulmonary Allergic Aspergillosis
D001249 Asthma A form of bronchial disorder with three distinct components: airway hyper-responsiveness (RESPIRATORY HYPERSENSITIVITY), airway INFLAMMATION, and intermittent AIRWAY OBSTRUCTION. It is characterized by spasmodic contraction of airway smooth muscle, WHEEZING, and dyspnea (DYSPNEA, PAROXYSMAL). Asthma, Bronchial,Bronchial Asthma,Asthmas
D001261 Pulmonary Atelectasis Absence of air in the entire or part of a lung, such as an incompletely inflated neonate lung or a collapsed adult lung. Pulmonary atelectasis can be caused by airway obstruction, lung compression, fibrotic contraction, or other factors. Atelectasis, Congestive,Lung Collapse,Atelectasis,Compression Atelectasis,Compression Pulmonary Atelectasis,Congestive Atelectasis,Congestive Pulmonary Atelectasis,Contraction Pulmonary Atelectasis,Postoperative Pulmonary Atelectasis,Resorption Atelectasis,Resorption Pulmonary Atelectasis,Atelectases,Atelectases, Compression,Atelectases, Compression Pulmonary,Atelectases, Congestive,Atelectases, Congestive Pulmonary,Atelectases, Contraction Pulmonary,Atelectases, Postoperative Pulmonary,Atelectases, Pulmonary,Atelectases, Resorption,Atelectases, Resorption Pulmonary,Atelectasis, Compression,Atelectasis, Compression Pulmonary,Atelectasis, Congestive Pulmonary,Atelectasis, Contraction Pulmonary,Atelectasis, Postoperative Pulmonary,Atelectasis, Pulmonary,Atelectasis, Resorption,Atelectasis, Resorption Pulmonary,Collapse, Lung,Compression Atelectases,Compression Pulmonary Atelectases,Congestive Atelectases,Congestive Pulmonary Atelectases,Contraction Pulmonary Atelectases,Postoperative Pulmonary Atelectases,Pulmonary Atelectases,Pulmonary Atelectases, Compression,Pulmonary Atelectases, Congestive,Pulmonary Atelectases, Contraction,Pulmonary Atelectases, Postoperative,Pulmonary Atelectases, Resorption,Pulmonary Atelectasis, Compression,Pulmonary Atelectasis, Congestive,Pulmonary Atelectasis, Contraction,Pulmonary Atelectasis, Postoperative,Pulmonary Atelectasis, Resorption,Resorption Atelectases,Resorption Pulmonary Atelectases
D014057 Tomography, X-Ray Computed Tomography using x-ray transmission and a computer algorithm to reconstruct the image. CAT Scan, X-Ray,CT Scan, X-Ray,Cine-CT,Computerized Tomography, X-Ray,Electron Beam Computed Tomography,Tomodensitometry,Tomography, Transmission Computed,X-Ray Tomography, Computed,CAT Scan, X Ray,CT X Ray,Computed Tomography, X-Ray,Computed X Ray Tomography,Computerized Tomography, X Ray,Electron Beam Tomography,Tomography, X Ray Computed,Tomography, X-Ray Computer Assisted,Tomography, X-Ray Computerized,Tomography, X-Ray Computerized Axial,Tomography, Xray Computed,X Ray Computerized Tomography,X Ray Tomography, Computed,X-Ray Computer Assisted Tomography,X-Ray Computerized Axial Tomography,Beam Tomography, Electron,CAT Scans, X-Ray,CT Scan, X Ray,CT Scans, X-Ray,CT X Rays,Cine CT,Computed Tomography, Transmission,Computed Tomography, X Ray,Computed Tomography, Xray,Computed X-Ray Tomography,Scan, X-Ray CAT,Scan, X-Ray CT,Scans, X-Ray CAT,Scans, X-Ray CT,Tomographies, Computed X-Ray,Tomography, Computed X-Ray,Tomography, Electron Beam,Tomography, X Ray Computer Assisted,Tomography, X Ray Computerized,Tomography, X Ray Computerized Axial,Transmission Computed Tomography,X Ray Computer Assisted Tomography,X Ray Computerized Axial Tomography,X Ray, CT,X Rays, CT,X-Ray CAT Scan,X-Ray CAT Scans,X-Ray CT Scan,X-Ray CT Scans,X-Ray Computed Tomography,X-Ray Computerized Tomography,Xray Computed Tomography

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