Epidemiology

• Predisposing Factors
  • Asthma (50% of cases have asthma with eosinophilia/antiboidies against Aspergillus and other fungi)
  • Ankylosing Spondylitis (see Ankylosing Spondylitis, [[Ankylosing Spondylitis]])
• Predisposed Groups: M>F

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Physiology

• Pulmonary vasculitis
  • Lymphocyte and plasma cell infiltrate/necrotizing granulomas (may contain Aspergillus)
• Probably an immune hypersensitivity response to fungi

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Diagnosis

• CBC: eosinophilia
• PFT’s: decreased DLCO, increased Vd/VT ratio
• Aspergillus Serology: may be positive
• Sputum c/s: Aspergillus may be found
• ABG: hypoxemia with elevated A-a gradient
• CXR: fleeting infiltrates/nodules/atelectasis
• OLB:

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Clinical

• Pulmonary Hypertension (see Pulmonary Hypertension, [[Pulmonary Hypertension]])

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Treatment

• Corticosteroids: may be useful

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References

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