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Prevalence of Allergic Bronchopulmonary Aspergillosis in Bronchial Asthma Patients: A Retrospective Observational
1Pulmonary Medicine, Postgraduate Institute of Medical Education and Research and Capital Hospital, Bhubaneswar, IND.
Abstract:
Background Asthma is a chronic inflammatory airway disease that can be exacerbated by fungal allergens, particularly Aspergillus fumigatus. Allergic bronchopulmonary aspergillosis (ABPA) is a severe hypersensitivity reaction observed in a subset of asthma patients. Objective To determine the prevalence of ABPA in patients with bronchial asthma and to describe their clinical, radiological, and immunological profiles. Methods This retrospective observational study was conducted over 18 months at a tertiary care hospital. Data from 100 bronchial asthma patients undergoing pulmonary function testing (PFT) were reviewed. ABPA diagnosis was based on criteria including elevated serum total IgE, specific IgE to A. fumigatus, chest X-ray findings, पigh-resolution computed tomography (HRCT), and eosinophilia. Results ABPA was diagnosed in 14% of asthma patients. The most common age group was 21-30 years. Male predominance (69%) was noted. Dyspnea (64%) was the most frequent symptom. ABPA was observed in 21% of mild, 7% of moderate, and 11% of severe asthma cases. Chest infiltrates had 100% sensitivity but low specificity (44.19%) for ABPA diagnosis. Conclusion ABPA is present in a significant proportion of asthma patients. Early identification is crucial due to treatment implications. Chest imaging and serum IgE levels are useful screening tools.
Insights
Allergic bronchopulmonary aspergillosis (ABPA) affects 14% of asthma patients, often presenting with dyspnea. Early screening using chest imaging and IgE levels is vital for timely treatment.
Area of Science:
- Pulmonology
- Allergy and Immunology
- Medical Diagnostics
Background:
- Asthma is a chronic airway inflammation exacerbated by fungal allergens like Aspergillus fumigatus.
- Allergic bronchopulmonary aspergillosis (ABPA) is a severe hypersensitivity reaction in some asthma patients.
- Understanding ABPA prevalence and characteristics in asthma is crucial for management.
Purpose of the Study:
- To determine the prevalence of ABPA in bronchial asthma patients.
- To describe the clinical, radiological, and immunological profiles of asthma patients with ABPA.
- To evaluate diagnostic utility of imaging and serological markers.
Main Methods:
- Retrospective observational study over 18 months at a tertiary care hospital.
- Reviewed data from 100 bronchial asthma patients undergoing pulmonary function testing (PFT).
- ABPA diagnosis based on serum IgE, specific IgE to A. fumigatus, chest imaging (X-ray, HRCT), and eosinophilia.
Main Results:
- ABPA diagnosed in 14% of asthma patients; common in 21-30 year olds (69% male).
- Dyspnea (64%) was the most frequent symptom.
- ABPA observed across asthma severity spectrum (mild 21%, moderate 7%, severe 11%); chest infiltrates showed high sensitivity but low specificity.
Conclusions:
- ABPA is present in a significant proportion of asthma patients, necessitating early identification.
- Chest imaging and serum IgE levels are valuable screening tools for ABPA in asthma.
- Prompt diagnosis of ABPA impacts treatment strategies and patient outcomes.
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