Development of Allergic Bronchopulmonary Aspergillosis in a Patient with Crohn's Disease

• Published in: Internal Medicine Vol. 58; no. 19; pp. 2835 - 2838
• Main Authors: Sasaki, Hisashi, Miyata, Jun, Maki, Yohei, Kimizuka, Yoshifumi, Hayashi, Nobuyoshi, Fujikura, Yuji, Kawana, Akihiko
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.10.2019; Japan Science and Technology Agency
• Subjects: Aged; Allergic bronchopulmonary aspergillosis; anti-tumor necrosis factor-α antibody; Antibodies, Fungal - immunology; Aspergillosis; Aspergillosis, Allergic Bronchopulmonary - diagnosis; Aspergillosis, Allergic Bronchopulmonary - etiology; Aspergillosis, Allergic Bronchopulmonary - microbiology; aspergillus; Aspergillus - immunology; asthma; Bronchiectasis; Case Report; Crohn Disease - complications; Crohn's disease; Dyspnea; Eosinophils - pathology; Humans; Immune response; Immunoglobulin E; Immunoglobulin E - immunology; Inflammation; inflammatory bowel disease; Inflammatory bowel diseases; Internal medicine; Leukocytes (eosinophilic); Lung - diagnostic imaging; Lung - physiopathology; Male; pulmonary disorder; Radiography, Thoracic; Respiration; Tomography, X-Ray Computed; Tumor necrosis factor-α; asthma; anti-tumor necrosis factor-α antibody; aspergillus; pulmonary disorder; inflammatory bowel disease
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.2785-19

Allergic bronchopulmonary aspergillosis (ABPA) is an eosinophilic inflammatory condition characterized by exaggerated immune responses to the fungal genus Aspergillus. Pulmonary manifestations in patients with Crohn's disease (CD) are frequent comorbidities. A 66-year-old man with CD treated with an anti-tumor necrosis factor-α antibody presented with dyspnea. Laboratory findings of elevated blood eosinophils and total serum IgE and positive aspergillus-specific antibodies as well as imaging findings of central bronchiectasis and mucoid impaction indicated a diagnosis of ABPA. To our knowledge, this is the first report of ABPA arising in a patient with CD. We discuss the pathophysiological mechanism of this rare complication.