Immediate-type reactions in patients with allergic bronchopulmonary aspergillosis

Allergic features of 38 patients with allergic bronchopulmonary aspergillosis (ABPA) were reviewed. These features included skin reactivity to other inhalant antigens and to molds other than Aspergillus fumigatus (Af) plus clinical manifestations of rhinitis, conjunctivitis, asthma, eczema, urticaria, anaphylaxis, food allergy, and drug allergy. ABPA patients have a high degree of allergic reactivity in all these clinical features, in particular, clearly documented food allergy. These findings differ from those previously reported in ABPA patients in England, where it was noted that patients with ABPA whose asthma began after age 30 had few manifestations of other allergic diseases. By contrast, our patients in the same age group (onset of asthma after age 30) had the same multiple allergic manifestations as younger patients. These results show that ABPA patients are a subset of atopic individuals with a greater predisposition for the development of a wide spectrum of allergic diseases, despite the lack of manifestations of other major immunologic disease patterns.