UNILATERAL LUNG COLLAPSE: A RARE CAUSE

Abstract

TYPE: Late Breaking Abstract TOPIC: Allergy and Airway INTRODUCTION: Allergic bronchopulmonary aspergillosis (ABPA) an allergic reaction to fungal antigens resulting in characteristic clinical and radiological mfeatures and is seen in patients asthma or cystic fibrosis. ABPA is characterised by uncontrolled asthma, wheezing, elevated agglutinins against aspergillus antigens,bilateral fleeting opacities on chest x-ray and central bronchiectasis..Immune response to Aspergillus antigens causes intense eosinophilic and neutrophilic inflammation and tenacious mucus secretions which can lead to airway obstruction and if untreated, bronchiectasis and pulmonary fibrosis CASE PRESENTATION: We report a middle aged lady who presented with a history of significant weight loss, chronic cough and breathing difficulty and was found to have complete left lung collapse with abrupt cut off left main bronchus on imaging. She was provisionally diagnosed as left lung collapse secondary to an endobronchial obstruction by a probable neoplastic lesion.Subsequent diagnosis of ABPA and conservative medical treatment led to complete resolution of the collapse over a period of 6 months. Serial chest x rays over 6 months DISCUSSION: Patients with ABPA can have diverse radiological manifestations. Although ABPA is usually a bilateral disease it is possible to have unilateral involvement which can in extreme instances lead to lung collapse . CONCLUSIONS: ABPA can rarely lead to unilateral lung collapse .When diagnosis is made early and treatment with steroid is initiated, irreversible lung damage can be prevented. Based on our case and similar reports we feel ABPA should be considered as a differential diagnosis whenever encountering a patient with total lung collapse and history of asthma. DISCLOSURE: I have been a member of the advisory board of M/s Cipla, M/s Glenmark pharmaceuticals, M/s Zydus cadila and am a member of the speakers bureau of M/s Astra Zeneca pharmaceuticals ( all of the above mentioned are pharmaceutical companies ) I hold shares o KEYWORD: ABPA