Bronchocentric Granulomatosis

Epidemiology

  • Predisposing Factors
    • Asthma (50% of cases have asthma with eosinophilia/antiboidies against Aspergillus and other fungi)
    • Ankylosing Spondylitis (see Ankylosing Spondylitis, [[Ankylosing Spondylitis]])
  • Predisposed Groups: M>F

Physiology

  • Pulmonary vasculitis
    • Lymphocyte and plasma cell infiltrate/necrotizing granulomas (may contain Aspergillus)
  • Probably an immune hypersensitivity response to fungi

Diagnosis

  • CBC: eosinophilia
  • PFT’s: decreased DLCO, increased Vd/VT ratio
  • Aspergillus Serology: may be positive
  • Sputum c/s: Aspergillus may be found
  • ABG: hypoxemia with elevated A-a gradient
  • CXR: fleeting infiltrates/nodules/atelectasis
  • OLB:

Clinical


Treatment

  • Corticosteroids: may be useful

References

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