Total unilateral pulmonary collapse secondary to allergic bronchopulmonary aspergillosis: a case series of an unusual cause of complete atelectasis.


Journal

BMC pulmonary medicine
ISSN: 1471-2466
Titre abrégé: BMC Pulm Med
Pays: England
ID NLM: 100968563

Informations de publication

Date de publication:
24 Dec 2021
Historique:
received: 27 03 2021
accepted: 07 12 2021
entrez: 25 12 2021
pubmed: 26 12 2021
medline: 1 2 2022
Statut: epublish

Résumé

Allergic bronchopulmonary aspergillosis (ABPA) is a bronchopulmonary disease caused by a complex hypersensitivity to Aspergillus and is usually associated with underlying respiratory diseases such as asthma or cystic fibrosis. Mucus plugging can lead to segmental or lobar atelectasis, but complete lung atelectasis has been exceptionally reported in the literature, making it difficult to diagnose. The diagnosis of ABPA may however be suggested in patients without known predisposing respiratory disorder, even in the absence of other relevant radiographic findings. We report five cases of total unilateral lung collapse secondary to ABPA in 70-81-year-old women. Two of them had a past history of ABPA, while total unilateral lung collapse was the first sign of the disease in the other three patients, contributing to the initial misdiagnosis. Flexible bronchoscopy was initially performed to remove mucus plugs from the obstructed airways but was inefficient in four cases. Corticosteroid and/or antifungal treatment was needed. ABPA can cause total unilateral lung collapse even in patients without known underlying chronic respiratory disease, making the diagnosis difficult. Flexible bronchoscopy should be considered when lung collapse is associated with respiratory distress but corticosteroids are the mainstay treatment for ABPA.

Sections du résumé

BACKGROUND BACKGROUND
Allergic bronchopulmonary aspergillosis (ABPA) is a bronchopulmonary disease caused by a complex hypersensitivity to Aspergillus and is usually associated with underlying respiratory diseases such as asthma or cystic fibrosis. Mucus plugging can lead to segmental or lobar atelectasis, but complete lung atelectasis has been exceptionally reported in the literature, making it difficult to diagnose. The diagnosis of ABPA may however be suggested in patients without known predisposing respiratory disorder, even in the absence of other relevant radiographic findings.
CASE PRESENTATION METHODS
We report five cases of total unilateral lung collapse secondary to ABPA in 70-81-year-old women. Two of them had a past history of ABPA, while total unilateral lung collapse was the first sign of the disease in the other three patients, contributing to the initial misdiagnosis. Flexible bronchoscopy was initially performed to remove mucus plugs from the obstructed airways but was inefficient in four cases. Corticosteroid and/or antifungal treatment was needed.
CONCLUSION CONCLUSIONS
ABPA can cause total unilateral lung collapse even in patients without known underlying chronic respiratory disease, making the diagnosis difficult. Flexible bronchoscopy should be considered when lung collapse is associated with respiratory distress but corticosteroids are the mainstay treatment for ABPA.

Identifiants

pubmed: 34952578
doi: 10.1186/s12890-021-01789-9
pii: 10.1186/s12890-021-01789-9
pmc: PMC8709957
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

425

Informations de copyright

© 2021. The Author(s).

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Auteurs

N Benkalfate (N)

Nantes Université, CHU Nantes, Service de Pneumologie, L'Institut du thorax, Nantes, 44000, France.

S Dirou (S)

Nantes Université, CHU Nantes, Service de Pneumologie, L'Institut du thorax, Nantes, 44000, France. stephanie.dirou@chu-nantes.fr.

P Germaud (P)

Nantes Université, CHU Nantes, Service de Pneumologie, L'Institut du thorax, Nantes, 44000, France.

C Defrance (C)

Nantes Université, CHU Nantes, Service de Radiologie et d'Imagerie Médicale, Unité d'Imagerie Thoracique et Générale, Nantes, 44000, France.

A Cavailles (A)

Nantes Université, CHU Nantes, Service de Pneumologie, L'Institut du thorax, Nantes, 44000, France.

T Pigeanne (T)

Service de Pneumologie, Centre Hospitalier Côte de Lumière, Les Sables d'Olonne, 85340, France.

M Robert (M)

Consultation de Pneumologie, Clinique Jules Verne, Nantes, 44300, France.

T Madjer (T)

Consultation de Pneumologie, Clinique Jules Verne, Nantes, 44300, France.

F Corne (F)

Nantes Université, CHU Nantes, Service de Pneumologie, L'Institut du thorax, Nantes, 44000, France.
Consultation de Pneumologie, Clinique Jules Verne, Nantes, 44300, France.

L Cellerin (L)

Nantes Université, CHU Nantes, Service de Pneumologie, L'Institut du thorax, Nantes, 44000, France.

C Sagan (C)

Nantes Université, CHU Nantes, Service d'Anatomopathologie, Nantes, 44000, France.

F X Blanc (FX)

Nantes Université, CHU Nantes, Service de Pneumologie, L'Institut du thorax, Nantes, 44000, France.

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