A case of allergic bronchopulmonary asperogillosis with atypical asthma / 알레르기

ABSTRACT

The tests for sputum acid fast bacilli and sputum cytology for malignancy were negative. The PC20 of bronchial methacholine challenge test was 20.2 mg/ml. Transbronchial lung biopsy showed bronchial inflammatory change with infiltration of eosinophils and the existence of fungal hypae. Antibody index for serum IgE-Af and IgG-Af was 10.2 and 2.1 respectively, comparing with Af-sensitive asthma patients. Recently we experienced an allergic bron-chopulmonary aspergillosis with atypical respiratory symptoms. Forty-seven years old female was admitted to our hospital because of cough, sputum, right pleuritic pain for 2 weeks. She had experienced pneumonia several times, but had been not confirmed any causative organism. On physical examination, breathing sound was decreased over right upper lung, but wheezing and crackle were not heard over both lungs. The chest X-ray showed segmental consolidation in right upper lobe, and HRCT showed tubular bronchiectasis and obstruction of right upper lobal bronchus due to mucoid impaction. Allergic skin prick test against Aspergillus fumigatus(Af) and serum preeipitin were negative, but intrader mal skin test was positive for Af. Specific IgE for Af was positive with class I. Total eosinophil count was 650/mm3, total IgE level was more than 3000 IU/ml, ESR was 62mm/hr, and eosinophils in induced sputum was 35%. The test for sputum acid fast bacilli and spu-Tum cytology for malignancy were negative. The PC20 of bronchial methacholine challenge-Test was 20.2 mg/ml. Transbronchial lung bi-Opsy showed bronchial inflammatory change With infiltration of eosinophils and the exis-Serum lgE-Af and lgG-Af was 10.2 and 2.1 Respectively, comparing with Af-sensitive Asthma patients.