Kumar Raj, Poongadan Mohammed Noufal, Singh Mandeep
Department of Respiratory Allergy and Applied Immunology, National Centre of Respiratory Allergy, Asthma and Immunology, India.
Pneumonol Alergol Pol. 2015;83(2):144-50. doi: 10.5603/PiAP.2015.0023.
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.
变应性支气管肺曲霉病（ABPA）是一种由辅助性T细胞2（Th2）介导的、针对曲霉的超敏性肺部疾病，通常影响哮喘患者和囊性纤维化（CF）患者。ABPA很少表现为肺萎陷，且这种表现在非哮喘患者中极为罕见。我们报告了三例ABPA表现为肺叶或全肺萎陷的病例。ABPA表现为患侧肺野透亮度减低的情况很罕见，文献中仅有少数病例报道。
首例病例为一名45岁不吸烟患者，有支气管哮喘病史，胸部放射学检查发现右侧肺野透亮度减低。第二例是一名62岁不吸烟、无哮喘的患者，表现为左肺萎陷。最后一例是一名哮喘男性患者，中叶萎陷。所有病例最终均被证实患有ABPA，治疗后临床和放射学表现均有显著改善。
本病例系列强调，对于表现为节段性或全肺萎陷的病例，在诊断这种可治疗疾病时需要采取积极的方法。如果早期发现，该病预后良好。
