A study of clinicoradiological profile in cases of allergic bronchopulmonary aspergillosis

Abstract

Introduction: Allergic bronchopulmonary aspergillosis (ABPA) is an immunologic pulmonary disorder caused by a complex hypersensitivity response to inhaled fungal antigens. ABPA occurs most commonly in immunocompetent patients and complicates 1% to 2% of cases of persistent asthma and 7% to 14% of cases of chronic steroid-dependent asthma. Aim: The aim of this study was to study the clinical and radiological profile of patients and to study the serological correlation of ABPA. Methodology: This was a retrospective study done over 6 months from June 2020 to December 2020. Patients who were confirmed cases of ABPA according to the International Society for Human and Animal Mycology criteria were enrolled for the study. Patients' demographic data, pathological, and radiological test results were collected and analyzed. Pre- and post-bronchodilator spirometry of the patients were examined and asthma control was calculated. Results: In the present study, 23 patients were studied. Most patients were young, the mean age was 35.7 years with a female predominance of 56.5%. The most common symptom was cough in 91.3% of patients. All patients had bronchial asthma as a predisposing factor. The mean absolute eosinophil count and mean serum immunoglobulin E were 534 cells/μL and 2270 UI/ml, respectively. About 82.6% of participants in the study had spirometry suggestive of obstructive pattern. Bronchiectasis and parenchymal opacities were the most common radiological abnormality seen. Conclusion: The diagnosis of ABPA must be considered when treating difficult to control asthma. A delay in diagnosis can lead to decreased asthma control, worsening of lung function, sometimes leading to irreversible changes, poor quality of life, and increased cost of treatment.

Keywords

• allergic bronchopulmonary aspergillosis
• asthma
• international society for human and animal mycology