Allergic bronchopulmonary aspergillosis: Brazilian Association of Allergy and Immunology guidelines for diagnosis and management

Abstract

A Aspergilose Broncopulmonar Alrgica (ABPA) uma doena imunoalrgica pulmonar causada por reaes de hipersensibilidade aos antgenos do fungo Aspergillus fumigatus.A doena afeta principalmente pessoas com asma ou fibrose cstica e pode levar a dano pulmonar irreversvel se no diagnosticada e adequadamente tratada.Apesar de descrita h quase 70 anos, a doena ainda subdiagnosticada.Isso pode estar relacionado aos mtodos de diagnstico utilizados, falta de testes padronizados e a critrios diagnsticos ainda imprecisos.O tratamento principal envolve o uso de corticosteroides sistmicos.Antifngicos azlicos so indicados para tratar exacerbaes e so a estratgia preferencial para reduzir o uso de corticosteroides.Medicamentos biolgicos prometem ser teis no tratamento da ABPA, devido sua capacidade de inibir a inflamao tipo 2, regular os nveis de eosinfilos e IgE e modular citocinas inflamatrias.Assim, frente a pacientes com asma, principalmente aqueles que tm dificuldade em alcanar o controle da doena, deve ser considerada a hipte-Allergic bronchopulmonary aspergillosis (ABPA) is an immunoallergic lung disease caused by hypersensitivity reactions to antigens of the fungus Aspergillus fumigatus.The disease primarily affects individuals with asthma or cystic fibrosis and can lead to irreversible lung damage if not accurately diagnosed and treated.Despite being described nearly 70 years ago, the disease remains underdiagnosed.This may be related to the diagnostic methods used, the lack of standardized tests, and still imprecise diagnostic criteria.Standard therapy involves the use of systemic corticosteroids.Azole antifungals are indicated for the treatment of exacerbations and are the preferred strategy to reduce corticosteroid use.Biologics hold promise for treating ABPA due to their ability to inhibit type 2 inflammation, regulate IgE levels and eosinophil counts, and modulate inflammatory cytokines.Thus, in patients with asthma, especially those with difficulty in achieving disease control, the possibility of ABPA should be considered.Given the variability of diagnostic criteria and the need

Key Biomarkers

Symptom Clusters