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Miliary nodules: An unusual presentation of allergic bronchopulmonary aspergillosis.

Aneja P, Singh UP, Kaur B, Patel K - Lung India (2014)

Bottom Line: The common radiological abnormalities encountered are fleeting pulmonary opacities, bronchiectasis, and mucoid impaction.Uncommon radiological findings encountered in ABPA include pulmonary masses, perihilar opacities simulating hilar adenopathy, and pleural effusions.It is often misdiagnosed and mismanaged as tuberculosis; thus, the clinician should be vigilant enough to diagnose this very rare entity.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab, India.

ABSTRACT
Allergic bronchopulmonary aspergillosis (ABPA) is an immune-mediated inflammatory disease caused by hypersensitivity to Aspergillus fumigatus. A wide spectrum of plain radiographic appearances has been described in ABPA, though none are pathognomonic of ABPA. The common radiological abnormalities encountered are fleeting pulmonary opacities, bronchiectasis, and mucoid impaction. Uncommon radiological findings encountered in ABPA include pulmonary masses, perihilar opacities simulating hilar adenopathy, and pleural effusions. However, miliary nodules as a radiological presentation of ABPA are very rare and only one case has been reported in literature. It is often misdiagnosed and mismanaged as tuberculosis; thus, the clinician should be vigilant enough to diagnose this very rare entity.

No MeSH data available.


Related in: MedlinePlus

Chest radiograph after steroid therapy that is essentially normal
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Figure 5: Chest radiograph after steroid therapy that is essentially normal

Mentions: A diagnosis of ABPA without bronchial asthma was thus made as the patient fulfilled majority of the criteria given by Rosenberg et al.[6] He was treated with prednisolone 0.75 mg/kg for 6 weeks, 0.5 mg/kg for next 6 weeks, then tapered by 5 mg every 6 week to continue for a total duration of 9 months. The patient showed marked improvement in his condition and there was marked clearing in his chest radiograph [Figure 5] after 3 months of treatment. TLC decreased markedly to 11,400 cells/mm3 with 61% neutrophils, 29% lymphocytes, and 10% eosinophils. The total serum IgE after 3 months of treatment decreased to 4784 IU/mL. The patient is under follow-up and no symptoms or signs of asthma have appeared till date.


Miliary nodules: An unusual presentation of allergic bronchopulmonary aspergillosis.

Aneja P, Singh UP, Kaur B, Patel K - Lung India (2014)

Chest radiograph after steroid therapy that is essentially normal
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4129607&req=5

Figure 5: Chest radiograph after steroid therapy that is essentially normal
Mentions: A diagnosis of ABPA without bronchial asthma was thus made as the patient fulfilled majority of the criteria given by Rosenberg et al.[6] He was treated with prednisolone 0.75 mg/kg for 6 weeks, 0.5 mg/kg for next 6 weeks, then tapered by 5 mg every 6 week to continue for a total duration of 9 months. The patient showed marked improvement in his condition and there was marked clearing in his chest radiograph [Figure 5] after 3 months of treatment. TLC decreased markedly to 11,400 cells/mm3 with 61% neutrophils, 29% lymphocytes, and 10% eosinophils. The total serum IgE after 3 months of treatment decreased to 4784 IU/mL. The patient is under follow-up and no symptoms or signs of asthma have appeared till date.

Bottom Line: The common radiological abnormalities encountered are fleeting pulmonary opacities, bronchiectasis, and mucoid impaction.Uncommon radiological findings encountered in ABPA include pulmonary masses, perihilar opacities simulating hilar adenopathy, and pleural effusions.It is often misdiagnosed and mismanaged as tuberculosis; thus, the clinician should be vigilant enough to diagnose this very rare entity.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab, India.

ABSTRACT
Allergic bronchopulmonary aspergillosis (ABPA) is an immune-mediated inflammatory disease caused by hypersensitivity to Aspergillus fumigatus. A wide spectrum of plain radiographic appearances has been described in ABPA, though none are pathognomonic of ABPA. The common radiological abnormalities encountered are fleeting pulmonary opacities, bronchiectasis, and mucoid impaction. Uncommon radiological findings encountered in ABPA include pulmonary masses, perihilar opacities simulating hilar adenopathy, and pleural effusions. However, miliary nodules as a radiological presentation of ABPA are very rare and only one case has been reported in literature. It is often misdiagnosed and mismanaged as tuberculosis; thus, the clinician should be vigilant enough to diagnose this very rare entity.

No MeSH data available.


Related in: MedlinePlus