Abstract
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.
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- Berger I., Phillips W. L., Shenker I. R. Pulmonary aspergillosis in childhood. A case report and discussion. Clin Pediatr (Phila) 1972 Mar;11(3):178–182. doi: 10.1177/000992287201100312. [DOI] [PubMed] [Google Scholar]
- HINSON K. F. W., MOON A. J., PLUMMER N. S. Broncho-pulmonary aspergillosis; a review and a report of eight new cases. Thorax. 1952 Dec;7(4):317–333. doi: 10.1136/thx.7.4.317. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Imbeau S. A., Cohen M., Reed C. E. Allergic bronchopulmonary aspergillosis in infants. Am J Dis Child. 1977 Oct;131(10):1127–1130. doi: 10.1001/archpedi.1977.02120230073013. [DOI] [PubMed] [Google Scholar]
- Katz R. M., Kniker W. T. Infantile hypersensitivity pneumonitis as a reaction to organic antigens. N Engl J Med. 1973 Feb 1;288(5):233–237. doi: 10.1056/NEJM197302012880504. [DOI] [PubMed] [Google Scholar]
- Malo J. L., Inouye T., Hawkins R., Simon G., Turner-Warwick M., Pepys J. Studies in chronic allergic bronchopulmonary aspergillosis. 4. Comparison with a group of asthmatics. Thorax. 1977 Jun;32(3):275–280. doi: 10.1136/thx.32.3.275. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McCarthy D. S., Pepys J. Allergic broncho-pulmonary aspergillosis. Clinical immunology. 2. Skin, nasal and bronchial tests. Clin Allergy. 1971 Dec;1(4):415–432. doi: 10.1111/j.1365-2222.1971.tb00793.x. [DOI] [PubMed] [Google Scholar]
- Mitchell-Heggs P., Mearns M., Batten J. C. Cystic fibrosis in adolescents and adults. Q J Med. 1976 Jul;45(179):479–504. [PubMed] [Google Scholar]
- Rosenberg M., Mintzer R., Aaronson D. W., Patterson R. Allergic bronchopulmonary aspergillosis in three patients with normal chest x-ray films. Chest. 1977 Nov;72(5):597–600. doi: 10.1378/chest.72.5.597. [DOI] [PubMed] [Google Scholar]
- Rosenberg M., Patterson R., Roberts M. Immunologic responses to therapy in allergic bronchopulmonary aspergillosis: serum IgE value as an indicator and predictor of disease activity. J Pediatr. 1977 Dec;91(6):914–917. doi: 10.1016/s0022-3476(77)80889-5. [DOI] [PubMed] [Google Scholar]
- Schwartz R. H., Johnstone D. E., Holsclaw D. S., Dooley R. R. Serum precipitins to Aspergillus fumigatus in cystic fibrosis. Am J Dis Child. 1970 Nov;120(5):432–433. doi: 10.1001/archpedi.1970.02100100096009. [DOI] [PubMed] [Google Scholar]
- Silverman M., Hobbs F. D., Gordon I. R., Carswell F. Cystic fibrosis, atopy, and airways lability. Arch Dis Child. 1978 Nov;53(11):873–877. doi: 10.1136/adc.53.11.873. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Turner M. W., Warner J. O., Stokes C. R. Immunological studies in cystic fibrosis. Arch Dis Child. 1978 Aug;53(8):631–638. doi: 10.1136/adc.53.8.631. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Warner J. O., Taylor B. W., Norman A. P., Soothill J. F. Association of cystic fibrosis with allergy. Arch Dis Child. 1976 Jul;51(7):507–511. doi: 10.1136/adc.51.7.507. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wood R. E., Boat T. F., Doershuk C. F. Cystic fibrosis. Am Rev Respir Dis. 1976 Jun;113(6):833–878. doi: 10.1164/arrd.1976.113.6.833. [DOI] [PubMed] [Google Scholar]