Brueton M J, Ormerod L P, Shah K J, Anderson C M
Arch Dis Child. 1980 May;55(5):348-53. doi: 10.1136/adc.55.5.348.
Allergic bronchopulmonary aspergillosis, known to be associated with cystic fibrosis in older patients, occurred in 7 young atopic children with cystic fibrosis. The diagnosis was suggested by the onset of, or the increase in, asthmatic symptoms accompanied by major chest x-ray changes ranging from total collapse of a lung or lobe to extensive but changing areas of consolidation. Each of the children had a blood eosinophilia, positive type I skin tests to Aspergillus fumigatus, and reversible airways obstruction. Most had a positive type III skin test and circulating precipitins to A. fumigatus, with raised IgE levels which contained specific antibodies to the fungus on radioallergosorbent (RAST) test. None had advanced suppurative chest disease of cystic fibrosis. None was given specific antifungal agents; two received systemic treatment with corticosteroids, the other received additional drugs for their asthma. Two developed total collapse of one lung, one child being only 2 years old. Five have had recurrences of pulmonary shadowing typical of allergic aspergillosis but are not showing significant progression of their cystic fibrosis lung disease. Our experience suggests that there should be an increased awareness of this condition, particularly its association with extensive pulmonary collapse or consolidation in children with cystic fibrosis who are atopic.
变应性支气管肺曲霉病在老年患者中已知与囊性纤维化相关，在7名患有囊性纤维化的特应性儿童中也有发生。诊断依据是哮喘症状的发作或加重，同时伴有胸部X线的主要改变，范围从一侧肺或肺叶的完全萎陷到广泛但变化的实变区域。每个儿童均有血液嗜酸性粒细胞增多、对烟曲霉的I型皮肤试验阳性以及可逆性气道阻塞。大多数儿童对烟曲霉的III型皮肤试验和循环沉淀素阳性，IgE水平升高，在放射变应原吸附试验（RAST）中含有针对该真菌的特异性抗体。无一例患有晚期囊性纤维化化脓性胸部疾病。无一例接受特异性抗真菌药物治疗；2例接受了全身性皮质类固醇治疗，另1例因其哮喘接受了其他药物治疗。2例出现一侧肺完全萎陷，其中1名儿童仅2岁。5例出现了变应性曲霉病典型的肺部阴影复发，但囊性纤维化肺病未显示明显进展。我们的经验表明，应提高对这种疾病的认识，尤其是其与患有囊性纤维化的特应性儿童广泛肺萎陷或实变的关联。
