The frequency of allergic bronchopulmonary aspergillosis in patients with asthma

Abstract EN

Background: Allergic bronchopulmonary aspergillosis ABPA is an unusual but not rare illness that affects young atopic adults with allergic asthma.

There are clinical and laboratory tests for the diagnosis of ABPA, these tests include history of asthma, peripheral blood eosinophilia, immediate cutaneous reactivity to Aspergillus fumigatus, serum precipitating antibodies to A.

fumigatus or elevated total serum IgE and radiological infiltration.

Objectives: This is a case control study designed to evaluate the frequency ofallergic bronchopulmonary aspergillosis ABPAin patients with asthma.

Methods: This is a case control study carried on 150 asthmatic patients consulting the allergic disease center of Aljumhori Teaching Hospital in Mosul for the period from November 2003 to July 2004 to identify patients with allergic bronchopulmonary aspergillosis ABPA.

Their ages ranged from 6-65 years, 52% of them were females and 48% were males.

The results were compared with a 60 apparently healthy individuals selected randomly as a control group.

To prove that patients’ symptoms were allergic bronchopulmonary aspergillosis ABPA, the following tests were performed for all patients, peripheral eosinophilia which was found in 40.6% of asthmatic patients, skin test for Aspergillus which was positive in 51.3%, ELISA test for total IgE which was positive in 28% and chest-X ray abnormalities were found in 17.3% of patients mainly as pulmonary infiltration.

Results:The major criteria for allergic bronchopulmonary aspergillosis ABPA were found in 19(12.6%) patients out of 150.

Moreover, it was significantly higher in most age groups mainly in those patients between 6-15 years and 16-25 years of age.

Peripheral eosinophilia, Skin test, ELISA and CXR did not appear to be related to the sex of patients or duration of asthma, but they were significantly higher than the control group (P<0.05) in those with atopic asthma associated with other allergic diseases as eczema, urticaria, rhinitis and conjunctivitis.

Conclusion:The current study revealed that 12.6% of asthmatic patients fulfill the criteria of allergic bronchopulmonary aspergillosis ABPA and there was a significant relationship between asthma and Aspergillus fumigatus as a risk factor.