<prompt> Features of allergic bronchopulmonary aspergillosis ABPA are all exceptBronchial asthmaCentral bronchiectasisPeripheral eosinophiliaRaised IgA levels  <response>: Ans. d Raised IgA levels. Ref. Harrisons 18thCh. 204ABPA represents a hypersensitivity reaction to A. fumigatus; rare cases are due to other aspergilli and other fungi. ABPA occurs in 1 of patients with asthma and in up to 15 of adults with cystic fibrosis. Episodes of bronchial obstruction with mucous plugs leading to coughing fits, pneumonia, consolidation, and breathlessness are typical. Eosinophilia commonly develops before systemic glucocorticoids are given. The cardinal diagnostic tests include an elevated serum level of total IgE usually 1000 IUmL, a positive skin-prick test to A. fumigatus extract, or detection of Aspergillus- specific IgE and IgG precipitating antibodies. Central bronchiectasis is characteristic. Primary Rx is Itraconazole therapy.ABPAPrimary diagnostic criteria for Allergic bronchopulmonary aspergillosis ABPASecondary diagnostic criteria less common1Asthma 84-96 Episodes of bronchospasm1Aspergillus fumigatus mycelias in sputum2Roentgenographic transient or fixed pulmonary infiltrates2Expectoration of brown sputum plugs 543Test for Aspergillus fumigatus positive skin3Arthus reaction to Aspergillus antigen.4Eosinophilia 8-404Fungal ball with Air crescent or Monads sign is characteristic of aspergilloma.5Precipitating antibodies to Aspergillus fumigatus 70 6IgE in serum elevated 7Central Proximalperihilar bronchiectasis late manifestation that proves diagnosis 8Serum specific IgE and IgG A. fumigatus levels elevated. 