[Allergic bronchopulmonary aspergillosis in a patient with no symptoms of asthma until after bronchial lavage].
An asymptomatic 56-year-old man was admitted to our hospital because of an abnormal shadow on a chest X-ray film. Allergic bronchopulmonary aspergillosis was diagnosed on the basis of five findings: eosinophilia, immediate skin reactivity to Aspergillus antigen, the presence of precipitating antibodies against Aspergillus antigen, a high concentration of IgE in serum, and central bronchiectasis. He had no symptoms of asthma at the time of diagnosis, but did a few days after he underwent bronchial lavage. We speculate that the asthma attack was related to the bronchial Lavage as follows: First, drainage of mucus plugs by bronchial lavage may have exposed the bronchial epithelium, which had already been sensitized, to aspergillus antigens. Second, the scattered antigen may have dose-dependently stimulated the bronchi. Third, the infection may have increased bronchial responsiveness to the antigen. Symptoms of bronchial asthma are not necessary for the diagnosis of allergic bronchopulmonary aspergillosis.
Yoshida
Y
Y
First Department of Internal Medicine, Toyama Medical and Pharmaceutical University.
Oosaki
R
R
Fujishita
T
T
Maruyama
M
M
Kobayashi
M
M
D001229:Aspergillosis, Allergic Bronchopulmonary / Q000175:diagnosis* / Q000276:immunology; D001249:Asthma / Q000209:etiology*; D001980:Bronchi / Q000276:immunology; D018893:Bronchoalveolar Lavage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged