Report Of Two Cases With Allergic Bronchopulmonaryaspergillosis And Literature Review

Objectives: To summarize the clinical manifestations,diagnosis and treatment of allergic bronchopulmonary aspergillosis(ABPA)and to improve clinicians’ learning of ABPA.Methods:Two cases of APBA accompanied with chronic obstructive plumonary disease in our hospital were reported,who had different prognosis.In Pubmed and China National Knowledge Infrastructure,allergic bronchopulmonary aspergillosis was used as a search term to collect all ABPA cases with well-documented data from 2008 to 2018 year.Clinical characteristics,diagnosis and treatment,and outcomes were summarized and analyzed.Results:A total of 52 cases of ABPA were retrieved.The ratio of male to female is 25:27,the average age is 40 years old,35% have ever been diagnosed as asthma.The most common clinical manifestations are cough,expectoration,paroxysmal asthma,shortness of breath,fever.Of 52 patients,all have elevated eosinophilic granulocyte ratio and total IgE level,62% appeared with elevated Aspergillus-specific IgE and IgG level,44%with positive rapid Aspergillus fumigatus skin test,63% appeared bronchiectasis,but central bronchiectasis was only 25%.Major patients accepted treatment with only glucocorticoids or combination with glucocorticoids and antifungal drugs,and most of them have good outcomes.Conclusions:ABPA is a lower respiratory allergic disease caused by inhalation of Aspergillus.Because the symptoms of ABPA are untypical,and the sensitivity and specificity of serum diagnostic antibodies test are not still ideal,it is very common to be misdiagnosed and mistreated.The best way to solve the deficiency is to improve clinicians’ diagnosis consciousness,optimal treatment scheme and follow-up management.