Occam's razor or Hickam's dictum? Allergic bronchopulmonary aspergillosis and eosinophilic granulomatosis with polyangiitis*

Coexistence of Eosinophilic Granulomatosis With Polyangiitis and Allergic Bronchopulmonary Aspergillosis: A Fascinating Relationship

“…Eight cases of coexisting EGPA and ABPA were included in this paper, bringing the total number of cases reviewed to nine (Table 1). Instances of concurrent EGPA and ABPA have been reported in the literature [10][11][12][13][14][15]. EGPA may precede or follow ABPA, and they can be diagnosed concurrently.…”

“…Some diagnostic criteria are common, and differential diagnosis is recommended. Several reports described the sequential occurrence of ABPA and EGPA, or vice versa [10][11][12][13][14][15]. How one established disease may predispose to the other is unknown, but it may include eosinophil recruitment by T helper 2 (Th2)-driven inflammation predisposing to fungal colonization and subsequent hypersensitivity [15].…”

Combined allergic bronchopulmonary mycosis and eosinophilic granulomatosis with polyangiitis: A case report and literature review

“…Considering long-term exposure to allergens may activate the immune response and lead to systemic eosinophilic vasculitis, some scholars believe that both ABPM and EGPA belong to adult-onset eosinophilic respiratory diseases and share common immune and pathological processes [ 2 ]. There were several cases of coexistence of ABPM and EGPA have been reported [ [3] , [4] , [5] , [6] , [7] , [8] , [9] ], in some cases ABPM was diagnosed prior to EGPA, in some cases EGPA was diagnosed prior to ABPM, and in some cases diagnosed simultaneously.…”

“…In cases which ABPM precedes EGPA, the abnormal Th2 response induced by long-term colonization of Aspergillus in the respiratory tract may lead to systemic eosinophilia and eosinophilic vasculitis. Many Aspergillus fumigatus antigens can stimulate humoral and cellular immune responses, directly or indirectly mediated by allergens that bind to IgE/IgG and stimulate CD4+Th2 cell subpopulations [ 7 ]. Aspergillus may stimulate the production of eosinophilic chemokine-3, a specific marker of EGPA, thereby promoting excessive aggregation and damage of eosinophils [ 12 ].…”

Combined Allergic bronchopulmonary mycosis and Eosinophilic Granulomatosis with Polyangiitis: A Case Report and Literature Review

“…In cases which ABPM precedes EGPA, the abnormal Th2 response induced by long-term colonization of Aspergillus in the respiratory tract may lead to systemic eosinophilia and eosinophilic vasculitis. Many Aspergillus fumigatus antigens can stimulate humoral and cellular immune responses, directly or indirectly mediated by allergens that bind to IgE/IgG and stimulate CD4+Th2 cell subpopulations (7). Aspergillus may stimulate the production of eosinophilic chemokine-3, a speci c marker of EGPA, thereby promoting excessive aggregation and damage of eosinophils (12).…”