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Allergische bronchopulmonale Aspergillose

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Seltene Lungenerkrankungen

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Zusammenfassung

Die allergische bronchopulmonale Aspergillose ist eine seltene, oft erst spät diagnostizierte Atemwegs- und Lungenerkrankung, die auf dem Boden eines allergischen Asthma bronchiale entsteht. Die klinischen Zeichen purulentes Sputum, rezidivierende pulmonale Infiltrate wechselnder Ausprägung bei einer kutan und serologisch nachweisbaren IgE-abhängigen Sensibilisierung gegen A. fumigatus und rekombinante A.-fumigatus-Antigene (oder seltener anderen Schimmelpilzen), gepaart mit einer labortechnisch nachweisbaren, ausgeprägten Eosinophilie und hohen, polyklonalen gesamt-IgE-Titern und dem Nachweis von Bronchiektasen, Mucoid Impaction und fibrotischen Veränderungen sollten die Diagnose einer ABPA nahelegen. Die Therapie umfasst immunsuppressive Behandlung mit systemischen und topischen Kortikosteroiden, Antimykotika und in Zukunft möglicherweise die Immuntherapie mit Anti-IgE- und/oder Anti-Zytokin-Antikörpern. Gesamt-IgE-Spiegel sind zur Therapiesteuerung geeignet.

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  1. Abteilungen für Pneumologie / Interdisziplinäre Internistische Intensivmedizin, Zentrum für Innere Medizin, Universitätsmedizin Rostock, Rostock, Deutschland

    J. Christian Virchow

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  1. J. Christian Virchow
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Correspondence to J. Christian Virchow .

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  1. Zentrum für interstitielle und seltene Lungenerkrankungen, Thoraxklinik, Universitätsklinikum Heidelberg, Heidelberg, Deutschland

    Michael Kreuter

  2. Ruhrlandklinik, Universitätsmedizin Essen, Essen, Deutschland

    Ulrich Costabel

  3. Thoraxklinik, Pneumologie und Beatmungsmedizin und Translational Lung Research Center (TLRCH), Universitätsklinikum Heidelberg, Heidelberg, Deutschland

    Felix JF Herth

  4. Vormals LungenClinic Grosshansdorf, Grosshansdorf, Deutschland

    Detlef Kirsten

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Virchow, J.C. (2022). Allergische bronchopulmonale Aspergillose. In: Kreuter, M., Costabel, U., Herth, F.J., Kirsten, D. (eds) Seltene Lungenerkrankungen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-63651-0_34

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  • DOI: https://doi.org/10.1007/978-3-662-63651-0_34

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