Allergic bronchopulmonary aspergillosis complicating chronic obstructive pulmonary disease

Allergic bronchopulmonary aspergillosis (ABPA) is a well recognised entity which complicates the course of 1-2% of patients with asthma and 2-15% of cystic fibrosis. Also, current criteria generally require the presence of asthma or cystic fibrosis for recognition of ABPA. The occurrence of ABPA in conditions other than cystic fibrosis or bronchial asthma is rare. Patients with chronic obstructive pulmonary disease (COPD) have mucus hypersecretion and impaired mucociliary clearance but are not reported to develop ABPA. Herein, we report a 50-year-old male who presented with an exacerbation of COPD due to co-existent ABPA. To our knowledge, this is the first report of such an association. We also speculate on mechanisms of causality and impact of ABPA on disease progression in COPD.