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Allergic Bronchopulmonary Mycosis

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Orphan Lung Diseases

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Abstract

Allergic bronchopulmonary aspergillosis (ABPA) is a common manifestation in chronic allergic asthma and cystic fibrosis (CF) patients. The role of epithelial cell dysfunctions and of the Th2 immune response (“Interleukin-4 (IL-4) hypersensitivity”), seems to be essential for developing an ABPA. Genetic factors associated with the occurrence of ABPA are identified. Different phenotypes of ABPA are described: the sero-positive ABPA, and the bronchiectasis ABPA. Sero-positive ABPA and bronchiectasis ABPA may be the illustration of two stages of the disease, time leading to an inevitable bronchial destruction. It may also be illustrate different expression of the disease. Genetic factors may favor one or the other of these two phenotypes. When clinical, radiological and biological criteria for ABPA appear in combination and the diagnosis is made, then the treatment would need to include both systemic corticosteroids and the antifungal agent itraconazole. However, treatment regimens for this antifungal therapy have yet to be definitively established, although many experts report the benefit of prolonged antifungal treatment.

We have a very special thought for the memory of Dr Isabelle Tillie-Leblond, who passed away soon after completing her chapter.

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Authors and Affiliations

  1. Pulmonary Department, University Hospital, INSERM U1019, Institut Pasteur de Lille, University of Lille 2, Lille, France

    Isabelle Tillie-Leblond MD, PhD

  2. Pulmonary Department, Medical University of Lille, Centre de compétences des maladies orphelines pulmonaires, Hôpital Calmette, 1 Boulevard Leclercq, 59037, Lille, France

    Isabelle Tillie-Leblond MD, PhD & Jean-François Bervar MD

  3. Pulmonary Department, University Hospital, INSERM U1019, Institut Pasteur de Lille, Lille, France

    Jean-François Bervar MD

  4. Paediatric Pulmonology and Allergology Unit, University Hospital Jeanne de Flandre, INSERM U1019, Institut Pasteur de Lille, Lille, France

    Antoine Deschildre MD

  5. Unité de pneumopédiatrie, Centre de compétence des maladies respiratoires rares, Université Lille 2 et CHRU, Hôpital Jeanne de Flandre, Avenue Eugène Avinée, 59037, Lille, France

    Antoine Deschildre MD

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  1. Isabelle Tillie-Leblond MD, PhD
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  1. Rare Pulmonary Diseases, Hôpital Louis Pradel, Lyon, France

    Vincent Cottin

  2. Rare Pulmonary Diseases, Hôpital Louis Pradel, Lyon, France

    Jean-Francois Cordier

  3. Respiratory Medicine, University of Southampton, Southampton, United Kingdom

    Luca Richeldi

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Tillie-Leblond, I., Bervar, JF., Deschildre, A. (2015). Allergic Bronchopulmonary Mycosis. In: Cottin, V., Cordier, JF., Richeldi, L. (eds) Orphan Lung Diseases. Springer, London. https://doi.org/10.1007/978-1-4471-2401-6_5

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