Development of Allergic Bronchopulmonary Aspergillosis in a Patient with Crohn's Disease

Intern Med. 2019 Oct 1;58(19):2835-2838. doi: 10.2169/internalmedicine.2785-19. Epub 2019 Jun 27.

Abstract

Allergic bronchopulmonary aspergillosis (ABPA) is an eosinophilic inflammatory condition characterized by exaggerated immune responses to the fungal genus Aspergillus. Pulmonary manifestations in patients with Crohn's disease (CD) are frequent comorbidities. A 66-year-old man with CD treated with an anti-tumor necrosis factor-α antibody presented with dyspnea. Laboratory findings of elevated blood eosinophils and total serum IgE and positive aspergillus-specific antibodies as well as imaging findings of central bronchiectasis and mucoid impaction indicated a diagnosis of ABPA. To our knowledge, this is the first report of ABPA arising in a patient with CD. We discuss the pathophysiological mechanism of this rare complication.

Keywords: anti-tumor necrosis factor-α antibody; aspergillus; asthma; inflammatory bowel disease; pulmonary disorder.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antibodies, Fungal / immunology
  • Aspergillosis, Allergic Bronchopulmonary / diagnosis
  • Aspergillosis, Allergic Bronchopulmonary / etiology*
  • Aspergillosis, Allergic Bronchopulmonary / microbiology
  • Aspergillus / immunology
  • Crohn Disease / complications*
  • Eosinophils / pathology
  • Humans
  • Immunoglobulin E / immunology
  • Lung / diagnostic imaging*
  • Lung / physiopathology
  • Male
  • Radiography, Thoracic
  • Tomography, X-Ray Computed

Substances

  • Antibodies, Fungal
  • Immunoglobulin E