AsthmaAllergic bronchopulmonary aspergillosis: an Indian perspectiveShah, Ashok Author Information Department of Respiratory Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India Correspondence to Professor Ashok Shah, Department of Respiratory Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, PO Box 2101, Delhi 110 007, India fax: +91 11 27667420; e-mail: [email protected] Current Opinion in Pulmonary Medicine: January 2007 - Volume 13 - Issue 1 - p 72-80 doi: 10.1097/MCP.0b013e328011a284 Buy Metrics Abstract Purpose of review Allergic bronchopulmonary aspergillosis is an immunologically mediated lung disease that is caused by hypersensitivity to antigens of the genus Aspergillus. This review summarizes the clinical presentation, radiologic profile, lung functions and immunologic studies on allergic bronchopulmonary aspergillosis from India. Data regarding Aspergillus sensitization in asthmatics are presented. The association of allergic bronchopulmonary aspergillosis with allergic Aspergillus sinusitis and aspergilloma is also highlighted. Recent findings Allergic bronchopulmonary aspergillosis is now an emerging disease in India. Sensitization to Aspergillus antigens is not uncommon in our patients with asthma. Although asthma commenced in these subjects in their early 20s, allergic bronchopulmonary aspergillosis was recognized more than a decade later. Allergic bronchopulmonary aspergillosis can also occur in patients without clinical asthma. Radiology is crucial to the diagnosis of allergic bronchopulmonary aspergillosis. The remarkable radiological similarity to pulmonary tuberculosis has important clinical implications in our country as patients with allergic bronchopulmonary aspergillosis often receive antituberculous therapy for a long time. Although oral corticosteroids still remain the cornerstone for management, itraconazole has emerged as an adjunct therapy in appropriate situations. Concomitant occurrence of allergic bronchopulmonary aspergillosis and allergic Aspergillus sinusitis is now being increasingly recognized. Summary All asthmatic subjects with a positive skin prick test to Aspergillus antigens must be evaluated for allergic bronchopulmonary aspergillosis and allergic Aspergillus sinusitis should be excluded. © 2007 Lippincott Williams & Wilkins, Inc.