Hypersensitivity Bronchopulmonary Aspergillosis

¹ Harry Webster Thorp Laboratories for the Division of Immunochemistry and Allergy, Royal Victoria, Montreal 2, Canada
² Professor of Experimental Medicine, McGill University

Seven patients with recurrent pulmonary densities, peripheral blood eosinophilia, purulent sputum with the fungus Aspergillus fumigatus and precipitating antibodies to extracts of this fungus were found to also have dual phase skin tests. These were characterized by an immediate component, reagin mediated, and a second phase, precipitin mediated, appearing three to six hours later. Biopsies of this latter phase showed perivascular infiltration with eosinophils, and deposition of IgG and B₁C, by immunofluorescence microscopy techniques. The patients varied in stages of illness. One had her first episode after a long history of recurrent asthma, several had recurring peisodes with one going on to develop a pulmonary mucus plug, and one presented with a mucus plug. Adrenal corticosteroids were used with excellent results, and are recommended for therapy.