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Aspergillus/allergic bronchopulmonary aspergillosis in an Irish cystic fibrosis population: a diagnostically

Sanjay Haresh Chotirmall1, Peter Branagan, Cedric Gunaratnam

  • 1Department of Respiratory Medicine, Beaumont Hospital. Dublin 1, Republic of Ireland. sanjaychotirmall@hotmail.com

Respiratory Care
|July 29, 2008
PubMed
Abstract

Insights

In Irish cystic fibrosis (CF) patients, 12% had allergic bronchopulmonary aspergillosis (ABPA). While Aspergillus colonization occurred in 30%, it did not impact long-term lung function, whereas ABPA caused temporary declines.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Allergy & Immunology

Background:

  • Cystic Fibrosis (CF) patients are susceptible to Aspergillus colonization.
  • Aspergillus acts as an allergen, potentially causing Allergic Bronchopulmonary Aspergillosis (ABPA).

Purpose of the Study:

  • To determine the prevalence of Aspergillus colonization and ABPA in Irish CF patients.
  • To assess the impact of colonization and ABPA on lung function.

Main Methods:

  • Sputum cultures and ABPA diagnostics were performed on 50 consecutive CF patients presenting with exacerbations.
  • Lung function (FEV1%) was monitored and compared between colonized and non-colonized groups, and in ABPA patients before and after treatment.

Main Results:

  • Aspergillus species were found in 30% of sputum cultures.
  • 12% of patients were diagnosed with ABPA.
  • Aspergillus colonization did not significantly affect long-term lung function (FEV1%).
  • ABPA patients experienced a short-term decline in lung function (mean 6.7% predicted FEV1) that resolved with treatment.

Conclusions:

  • The prevalence of ABPA in this Irish CF cohort was 12%.
  • Aspergillus colonization alone is not a negative prognostic indicator for lung function in CF.
  • ABPA leads to reversible lung function decline and responds to treatment.
  • A high index of suspicion for ABPA is recommended in CF patients unresponsive to antibiotics.

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