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http://dx.doi.org/10.1136/bcr-2017-221591DOI Listing

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Pulmonary overlap syndrome in a patient with bronchial asthma.

BMJ Case Rep

January 2025

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Allergic bronchopulmonary aspergillosis (ABPA) is a disease of immunocompetent patients, and invasive pulmonary aspergillosis is seen in immunocompromised patients. Hence, pulmonary overlap syndrome presenting with ABPA and invasive aspergillosis is extremely rare. We report a case of well-controlled bronchial asthma who presented with acute exacerbation and hypoxaemic respiratory failure.

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Purpose: The study evaluated the effects of elexacaftor/tezacaftor/ivacaftor (ETI) therapy in people with cystic fibrosis (pwCF) and a clinical history of Aspergillus fumigatus (AF) infection.

Methods: This prospective cohort study included pwCF who initiated ETI therapy and had received antifungal treatment in the preceding five years due to allergic bronchopulmonary aspergillosis (ABPA group) or other AF-related clinical manifestations (AF group). A control group of pwCF with no prior respiratory cultures positive for AF was also included.

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Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity reaction observed in asthma as well as cystic fibrosis (CF) patients due to the colonization of the airways by Aspergillus fumigatus. While ABPA is most commonly observed in CF patients (2-9%), it is seen at a rate of 1-2% in patients diagnosed with asthma. ABPA is mostly seen in steroid dependent adult asthma patients and has rarely been reported in pediatric asthma patients.

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