Allergic Bronchopulmonary Aspergillosis
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Allergic bronchopulmonary aspergillosis is a condition common with those suffering from long-term conditions like cystic fibrosis and asthma. It develops when they breathe in Aspergillus fumigates, a type of fungus. Aspergillus fumigates upon access into the lungs causes a negative reaction. That negative reaction to Aspergillus fumigates is what allergic bronchopulmonary aspergillosis is.
ABPA can be managed with medications.
What causes allergic bronchopulmonary aspergillosis?
It is a fungus-induced negative reaction. The name of the fungus is aspergillus fumigates.
It can be found in dust, water, and soil. It can only cause ABPA when inhaled. It can cause recurring lung inflammation when not well-treated.
Approximately 2-11% of people suffering from cystic fibrosis were also found to have ABPA according to statistics from the Cystic Fibrosis Foundation. Another finding has it that 13% of people who had asthma also had ABPA. Children aged between 10 and 17 are more likely to have ABPA than girls of the same age.
What are the symptoms of allergic bronchopulmonary aspergillosis?
Because allergic bronchopulmonary aspergillosis coexists with asthma and cystic fibrosis, their symptoms tend to look alike. So, you can have cystic fibrosis or asthma without knowing you also have ABPA.
Certain signs often come first when you have ABPA. They often include:
- wheezing
- mild fever
- shortness of breath
- brownish mucus-stained coughs
Other symptoms include:
- exercise-induced asthma attacks
- increased mucus discharge from coughs
How serious is allergic bronchopulmonary aspergillosis?
When ABPA becomes very severe, permanent changes will occur in your central airways. Such permanent changes include widened airways. The widening of the airways will often result in bronchiectasis. Bronchiectasis can further precipitate respiratory and cardiac abnormalities. People with the advanced form of cystic fibrosis will more likely suffer from these serial complications.
How is allergic bronchopulmonary aspergillosis diagnosed?
ABPA is one condition that has proven to be quite difficult to diagnose because of the resemblance of its symptoms with those of asthma and cystic fibrosis. Different tests will hence be used to ensure that no other condition other than asthma and cystic fibrosis is responsible for its development. Pneumonia can also cause ABPA.
Such tests include:
- chest X-rays or CT scans – either of these two tests can be used to evaluate the state of the lungs especially to see if they have become widened
- blood tests – special white blood cells called eosinophils are tested for in the blood because allergic substances enhance their concentration in the blood
- sputum/phlegm culture – from your sputum, eosinophils and Aspergillus can be detected
- Skin test – it will be used to evaluate allergic reactions of your skin to Aspergillus. That’s all this test can do. It lacks the ability to differentiate between a normal allergy to Aspergillus and ABPA.
How is allergic bronchopulmonary aspergillosis diagnosed?
The treatment of ABPA involves alleviating its symptoms whenever there is a flare-up.
Its treatment is also preventive in the sense that further occurrence is prevented.
Treating Inflammation
Corticosteroids (e.g. prednisone) are known for their good work against inflammatory conditions. They come in different forms: liquid and pills.
Corticosteroids must be taken for several weeks after which there will be a gradual reduction in their use. Once the symptoms have ‘checked out’ completely, you can discontinue taking them, but not without your doctor’s consent.
You can’t escape experiencing weight gain, increased inclination to eat, and a runny stomach from corticosteroids.
In addition to corticosteroids, you are likely to be given some medications for asthma. These medications will help in improving your airways. With these medications, you will also be able to cough up more mucus. Coughing up more mucus mean more removal of aspergillus fumigate from your lungs.
Treating the Fungus
Antifungal medication like itraconazole can prevent the worsening of ABPA. Antifungal medications do this by clearing much of the aspergillus fumigates out of your airways. This is one medication you can take for 6 months and you have to take it twice every day. There are some exceptional cases where you might have to take the medication for less than 6 months. The difference lies in whether the symptoms go away before the 6 months or not. Should the symptoms clear up before 6 months, do well to notify your doctor. You might have to complete the dosage anyways to avoid future flare-ups.
Rashes, fever, and stomach upset are some of the side effects to expect from antifungal medications.
Can allergic bronchopulmonary aspergillosis be prevented?
Yes and no! Yes, future flare-ups can be prevented if you stick to the recommended prescription after treatment! No, if you are often exposed to environments that have a high concentration of Aspergillus!
What is the outlook?
ABPA is one illness that can increase
You must therefore go for check-ups on your lungs from time to time. With a close ‘eye’ on your lung functions and eosinophil concentration, ABPA can be stopped from reoccurring.
Tonika Bruce, also known as The Network Nurse, is a multi-talented individual with a career spanning over 20 years. She’s a Registered Nurse, speaker, author, and advocate for change, excelling in business building and team development. Tonika holds two Master’s degrees in Nursing and Business Administration, (MSN & MBA) and is currently pursuing her Doctorate of Nursing Practice in Executive Leadership.
Her expertise extends to various fields such as nursing, entrepreneurship, business, basketball coaching, and executive leadership. She is a published author of “Relentless Pursuit: Proven Tips for Unlocking Your Potentials, Limitless Success and Post COVID Syndrome: A Guide to Repositioning the Nursing Profession for A Post COVID Era”. Currently, Tonika is working on Thrudemic, an anthology examining the impact of the coronavirus pandemic on medical professionals and patients.
