Which of the following is not a feature of ABPA
High-Yield Explanation
Ref. API Textbook of Medicine. Pg. 1751
Allergic Bronchopulmonary Aspergillosis
ABPA represents a hypersensitivity reaction to A. fumigatus; rare cases are due to other aspergilli and other fungi.
ABPA occurs in ~1% of patients with asthma and in up to 15% of adults with cystic fibrosis; occasional cases are reported in patients with neither of the latter.
Episodes of bronchial obstruction with mucous plugs leading to coughing fits, "pneumonia," consolidation, and breathlessness are typical.
Many patients report coughing up thick sputum casts, usually brown or clear.
Eosinophilia commonly develops before systemic glucocorticoids are given.
The cardinal diagnostic tests include an elevated serum level of total IgE (usually >1000 IU/mL), a positive skin-prick test to A. fumigatus extract, or detection of Aspergillus-specific IgE and IgG (precipitating) antibodies.
Central bronchiectasis is characteristic