Clinical and radiological signs of ABPA associated with airways infection with Aspergillus in the absence of specific IgE.
Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus that mainly affects patients with asthma. For diagnosis, elevated serum IgE level are needed according to Greenberger and Patterson criteria. We report a case of 43 years-old woman who developed ABPA with productive cough, fever and radiological findings of multiple confluent areas of consolidation in both upper lobes. Laboratory tests showed elevated peripheral eosinophil counts (9.3 x 10(3)/ml). In bronchial washing A. galactomannans and A. Fumigatus were isolated, although we found normal levels of serum IgE, and the absence of serum IgG and IgE antibodies to Aspergillus and A. galactomannans. In conclusion, clinical and radiological signs of ABPA can be associated with Aspergillus infection also in the absence of a specific serum antibody reaction.
Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome Tor Vergata, Rome, Italy. E-mail: flavia.sunzini@gmail.com.
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Sunzini
Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome Tor Vergata, Rome, Italy.
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Barbato
Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome Tor Vergata, Rome, Italy.
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Canofari
Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome Tor Vergata, Rome, Italy.
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Lugari
Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome Tor Vergata, Rome, Italy.
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Perricone
Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome Tor Vergata, Rome, Italy.
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Bergamini
D000328:Adult; D000908:Antibodies, Fungal / Q000097:blood*; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D001232:Aspergillus fumigatus / Q000276:immunology* / Q000302:isolation & purification; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008168:Lung / Q000000981:diagnostic imaging* / Q000276:immunology / Q000382:microbiology; D011237:Predictive Value of Tests; D012129:Respiratory Function Tests; D012698:Serologic Tests; D014057:Tomography, X-Ray Computed
D000908:Antibodies, Fungal; D015415:Biomarkers; D007073:Immunoglobulin E
Aspergillus; IgE; allergic bronchopulmonary aspergillosis