Abstract

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. 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. 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.

Highlights

  • 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 has been classified into ABPA Seropositive (ABPA-S), ABPA-Central Bronchiectasis (ABPA-CB) and ABPA Other Radiological Findings (ABPA-CB-ORF) based on the radiological picture, with both the severity of the radiological and serologic findings increasing from patients with ABPA-S to those with ABPA-CB-ORF [6]

  • ABPA rarely presents as lung collapse and such kind of presentation is very rare in non-asthmatic patients

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Summary

Introduction

Allergic bronchopulmonary aspergillosis (ABPA) is a T-helper cell 2 (Th2) mediated hypersensitive lung disorder in response to Aspergillus fumigatus that affects asthmatic and cystic fibrosis (CF) patients [1]. It is one of the most frequently recognized manifestation of allergic aspergillosis, occurs worldwide and is seen as an important emerging disease in India [2]. Case 1 A 45-year-old non-smoker male presented to us with 10 year history of episodic cough and breathlessness aggravated with change of season. High resolution computed tomography (HRCT) showed right lung collapse with mediastinal shift to the right (Fig. 2A). At presentation patient was on antitubercular therapy for the last five months based on chest radiogram and lung HRCT while

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