Current Approach in the Diagnosis and Management of Allergic Bronchopulmonary Aspergillosis in Children With Cystic Fibrosis

Allergic bronchopulmonary aspergillosis (ABPA) is a complex pulmonary disorder characterized by a hypersensitivity reaction to Aspergillus fumigatus, and almost always seen in patients with cystic fibrosis (CF) and asthma. Fungal hyphae leads to an ongoing inflammation in the airways that may result...

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Main Authors: Birce Sunman, Dilber Ademhan Tural, Beste Ozsezen, Nagehan Emiralioglu, Ebru Yalcin, Uğur Özçelik
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-10-01
Series:Frontiers in Pediatrics
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fped.2020.582964/full
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author Birce Sunman
Dilber Ademhan Tural
Beste Ozsezen
Nagehan Emiralioglu
Ebru Yalcin
Uğur Özçelik
author_facet Birce Sunman
Dilber Ademhan Tural
Beste Ozsezen
Nagehan Emiralioglu
Ebru Yalcin
Uğur Özçelik
author_sort Birce Sunman
collection DOAJ
description Allergic bronchopulmonary aspergillosis (ABPA) is a complex pulmonary disorder characterized by a hypersensitivity reaction to Aspergillus fumigatus, and almost always seen in patients with cystic fibrosis (CF) and asthma. Fungal hyphae leads to an ongoing inflammation in the airways that may result in bronchiectasis, fibrosis, and eventually loss of lung function. Despite the fact that ABPA is thought to be more prevalent in CF than in asthma, the literature on ABPA in CF is more limited. The diagnosis is challenging and may be delayed because it is made based on a combination of clinical features, and radiologic and immunologic findings. With clinical deterioration of a patient with CF, ABPA is important to be kept in mind because clinical manifestations mimic pulmonary exacerbations of CF. Early diagnosis and appropriate treatment are important in preventing complications related to ABPA. Treatment modalities involve the use of anti-inflammatory agents to suppress the immune hyperreactivity and the use of antifungal agents to reduce fungal burden. Recently, in an effort to treat refractory patients or to reduce adverse effects of steroids, other treatment options such as monoclonal antibodies have started to be used. Intensive research of these new agents in the treatment of children is being conducted to address insufficient data.
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spelling doaj.art-351815f5a8e94c1e83eda84c548e15dd2022-12-21T23:51:43ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602020-10-01810.3389/fped.2020.582964582964Current Approach in the Diagnosis and Management of Allergic Bronchopulmonary Aspergillosis in Children With Cystic FibrosisBirce SunmanDilber Ademhan TuralBeste OzsezenNagehan EmiraliogluEbru YalcinUğur ÖzçelikAllergic bronchopulmonary aspergillosis (ABPA) is a complex pulmonary disorder characterized by a hypersensitivity reaction to Aspergillus fumigatus, and almost always seen in patients with cystic fibrosis (CF) and asthma. Fungal hyphae leads to an ongoing inflammation in the airways that may result in bronchiectasis, fibrosis, and eventually loss of lung function. Despite the fact that ABPA is thought to be more prevalent in CF than in asthma, the literature on ABPA in CF is more limited. The diagnosis is challenging and may be delayed because it is made based on a combination of clinical features, and radiologic and immunologic findings. With clinical deterioration of a patient with CF, ABPA is important to be kept in mind because clinical manifestations mimic pulmonary exacerbations of CF. Early diagnosis and appropriate treatment are important in preventing complications related to ABPA. Treatment modalities involve the use of anti-inflammatory agents to suppress the immune hyperreactivity and the use of antifungal agents to reduce fungal burden. Recently, in an effort to treat refractory patients or to reduce adverse effects of steroids, other treatment options such as monoclonal antibodies have started to be used. Intensive research of these new agents in the treatment of children is being conducted to address insufficient data.https://www.frontiersin.org/articles/10.3389/fped.2020.582964/fullABPAallergic bronchopulmonary aspergillosisaspergilluscystic fibrosischildren
spellingShingle Birce Sunman
Dilber Ademhan Tural
Beste Ozsezen
Nagehan Emiralioglu
Ebru Yalcin
Uğur Özçelik
Current Approach in the Diagnosis and Management of Allergic Bronchopulmonary Aspergillosis in Children With Cystic Fibrosis
Frontiers in Pediatrics
ABPA
allergic bronchopulmonary aspergillosis
aspergillus
cystic fibrosis
children
title Current Approach in the Diagnosis and Management of Allergic Bronchopulmonary Aspergillosis in Children With Cystic Fibrosis
title_full Current Approach in the Diagnosis and Management of Allergic Bronchopulmonary Aspergillosis in Children With Cystic Fibrosis
title_fullStr Current Approach in the Diagnosis and Management of Allergic Bronchopulmonary Aspergillosis in Children With Cystic Fibrosis
title_full_unstemmed Current Approach in the Diagnosis and Management of Allergic Bronchopulmonary Aspergillosis in Children With Cystic Fibrosis
title_short Current Approach in the Diagnosis and Management of Allergic Bronchopulmonary Aspergillosis in Children With Cystic Fibrosis
title_sort current approach in the diagnosis and management of allergic bronchopulmonary aspergillosis in children with cystic fibrosis
topic ABPA
allergic bronchopulmonary aspergillosis
aspergillus
cystic fibrosis
children
url https://www.frontiersin.org/articles/10.3389/fped.2020.582964/full
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