Question
40 year old patient with history of prolonged exposure to Aspergillus presents with repeated episodes of breathlessness.CT Chest represent the following as shown below.Skin hypersensitivity test is positive for Aspergillus antigen Peripheral blood picture shows normal eosinophil count and serum IgE levels are normal The most likely diagnosis is ?
A. Allergic bronchial Asthma.
B. Allergic Bronchopulmonary Aspergillosis (ABPA).
C. Extrinsic Allergic Alveolitis.
D. Invasive Pulmonary Aspergillosis.
Show Answer
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Correct Answer » C
Explanation
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CT Chest as shown above with normal levels of IgE and absence of peripheral eosinophilia is characteristic of Extrinsic Allergic Alveolitis.
Hypersensitivity Reaction to Aspergillus
Hypersensitivity Lung diseases that result from exposure to A. Fumigatus allergens include Bronchial Asthma, ABPA and Extrinsic Allergic Alveolitis (Hypersensitivity Pneumonitis)
In Atopic Individual
Allergic Bronchial Asthma and ABPA
Allergic Bronchial Asthma and ABPA are seen in atopic individuals and immune response is IgE mediate.
In Non atopic Individuals
Extrinsic Allergic Alveolitis (Hypersensitivity penumonitis)
Extrinsic Allergic Alveolitis or Hypersensitivity penumonitis is seen in non atopic individuals and immune response is not IgE mediated.
Immune response may involve cell mediated (type IV) or immune complex (Type III) reactions.
