Allergic Bronchopulmonary Aspergillosis in Patients with Cystic Fibrosis and Non-cystic Fibrosis Bronchiectasis

Overview

Journal Electron Physician

Specialty General Medicine

Date 2018 Mar 29

PMID 29588830

Citations 1

Authors

Soheila Alyasin

Mozhgan Moghtaderi

Shirin Farjadian

Maryam Babaei

Saeed Hosseini Teshnizi

Affiliations

Soon will be listed here.

Abstract

Background: Aspergillus sensitization (AS) and allergic bronchopulmonary aspergillosis (ABPA) can occur as a cause of permanent lung damage in patients with cystic fibrosis (CF) and non-CF bronchiectasis.

Objective: The aim of this study was to determine the frequency of AS and ABPA in patients with CF and non-CF bronchiectasis in southwestern Iran.

Methods: This cross-sectional study was conducted on 33 patients with CF and 27 patients with non-CF bronchiectasis from southwestern Iran who were referred to Namazi Hospital affiliated to Shiraz University of Medical Sciences from July 2015 to February 2016. Skin prick test to Aspergillus fumigatus, peripheral blood eosinophil count, total serum IgE, specific IgE and IgG against Aspergillus fumigatus as well as radiologic chest studies were done for each patient. Statistical analysis was done by Mann-Whitney U test, Fisher Exact test, and Kappa weighted in SPSS software version 18. Level of significance was set at p<0.05.

Results: Nine patients with CF (27.3%) and one patient with non-CF bronchiectasis (3.7%) had positive skin tests to Aspergillus. There was 81.2% agreement between positive skin test and specific IgE to Aspergillus fumigatus (p<0.001). Three patients with CF (9%) met the diagnostic criteria for ABPA, whereas ABPA was not seen in patients with non-CF bronchiectasis.

Conclusion: ABPA was low in this study, considering more frequency of AS in patients with cystic fibrosis, clinicians should keep in mind the diagnosis of ABPA for those CF patients that do not respond to usual medical therapy and have positive skin tests to Aspergillus allergens.

Citing Articles

Immunomodulation in Cystic Fibrosis: Why and How?.

Giacalone V, Dobosh B, Gaggar A, Tirouvanziam R, Margaroli C Int J Mol Sci. 2020; 21(9).

PMID: 32397175 PMC: 7247557. DOI: 10.3390/ijms21093331.

References

Jones A, Horsley A, Denning D . What is the importance of classifying Aspergillus disease in cystic fibrosis patients?. Expert Rev Respir Med. 2014; 8(4):389-92. DOI: 10.1586/17476348.2014.915751. View

Menzies D, Holmes L, McCumesky G, Prys-Picard C, Niven R . Aspergillus sensitization is associated with airflow limitation and bronchiectasis in severe asthma. Allergy. 2011; 66(5):679-85. DOI: 10.1111/j.1398-9995.2010.02542.x. View

Altenburg J, Wortel K, van der Werf T, Boersma W . Non-cystic fibrosis bronchiectasis: clinical presentation, diagnosis and treatment, illustrated by data from a Dutch Teaching Hospital. Neth J Med. 2015; 73(4):147-54. View

McShane P, Naureckas E, Tino G, Strek M . Non-cystic fibrosis bronchiectasis. Am J Respir Crit Care Med. 2013; 188(6):647-56. DOI: 10.1164/rccm.201303-0411CI. View

Barton R, Hobson R, Denton M, Peckham D, Brownlee K, Conway S . Serologic diagnosis of allergic bronchopulmonary aspergillosis in patients with cystic fibrosis through the detection of immunoglobulin G to Aspergillus fumigatus. Diagn Microbiol Infect Dis. 2008; 62(3):287-91. DOI: 10.1016/j.diagmicrobio.2008.06.018. View

Klimova B, Kuca K, Novotny M, Maresova P . Cystic Fibrosis Revisited - a Review Study. Med Chem. 2016; 13(2):102-109. DOI: 10.2174/1573406412666160608113235. View

Agarwal R, Chakrabarti A, Shah A, Gupta D, Meis J, Guleria R . Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria. Clin Exp Allergy. 2013; 43(8):850-73. DOI: 10.1111/cea.12141. View

Sharma V, D Raj , Xess I, Lodha R, Kabra S . Prevalence and risk factors for allergic bronchopulmonary aspergillosis in Indian children with cystic fibrosis. Indian Pediatr. 2014; 51(4):295-7. View

Geller D, Kaplowitz H, Light M, Colin A . Allergic bronchopulmonary aspergillosis in cystic fibrosis: reported prevalence, regional distribution, and patient characteristics. Scientific Advisory Group, Investigators, and Coordinators of the Epidemiologic Study of Cystic Fibrosis. Chest. 1999; 116(3):639-46. DOI: 10.1378/chest.116.3.639. View

10.

Greenberger P . Allergic bronchopulmonary aspergillosis. J Allergy Clin Immunol. 2002; 110(5):685-92. DOI: 10.1067/mai.2002.130179. View

11.

Maturu V, Agarwal R . Prevalence of Aspergillus sensitization and allergic bronchopulmonary aspergillosis in cystic fibrosis: systematic review and meta-analysis. Clin Exp Allergy. 2015; 45(12):1765-78. DOI: 10.1111/cea.12595. View

12.

Singh M, Rebordosa C, Bernholz J, Sharma N . Epidemiology and genetics of cystic fibrosis in Asia: In preparation for the next-generation treatments. Respirology. 2015; 20(8):1172-81. DOI: 10.1111/resp.12656. View

13.

Dodd J, Lavelle L, Fabre A, Brady D . Imaging in cystic fibrosis and non-cystic fibrosis bronchiectasis. Semin Respir Crit Care Med. 2015; 36(2):194-206. DOI: 10.1055/s-0035-1546749. View

14.

Ryan M, Marple B . Allergic fungal rhinosinusitis: diagnosis and management. Curr Opin Otolaryngol Head Neck Surg. 2007; 15(1):18-22. DOI: 10.1097/MOO.0b013e328013dbd9. View

15.

Farjadian S, Moghtaderi M, Kashef S, Alyasin S, Najib K, Saki F . Clinical and genetic features in patients with cystic fibrosis in southwestern iran. Iran J Pediatr. 2013; 23(2):212-5. PMC: 3663315. View

16.

Mastella G, Rainisio M, Harms H, Hodson M, Koch C, Navarro J . Allergic bronchopulmonary aspergillosis in cystic fibrosis. A European epidemiological study. Epidemiologic Registry of Cystic Fibrosis. Eur Respir J. 2000; 16(3):464-71. DOI: 10.1034/j.1399-3003.2000.016003464.x. View

17.

Saunders R, Modha D, Claydon A, Gaillard E . Chronic Aspergillus fumigatus colonization of the pediatric cystic fibrosis airway is common and may be associated with a more rapid decline in lung function. Med Mycol. 2016; 54(5):537-43. DOI: 10.1093/mmy/myv119. View

18.

Stevens D, Kan V, Judson M, Morrison V, Dummer S, Denning D . Practice guidelines for diseases caused by Aspergillus. Infectious Diseases Society of America. Clin Infect Dis. 2000; 30(4):696-709. DOI: 10.1086/313756. View

19.

Sehgal I, Dhooria S, Bal A, Agarwal R . Allergic bronchopulmonary aspergillosis in an adult with Kartagener syndrome. BMJ Case Rep. 2015; 2015. PMC: 4533605. DOI: 10.1136/bcr-2015-211493. View

20.

Jalalirad M, Houshmand M, Mirfakhraie R, Goharbari M, Mirzajani F . First study of CF mutations in the CFTR gene of Iranian patients: detection of DeltaF508, G542X, W1282X, A120T, R117H, and R347H mutations. J Trop Pediatr. 2004; 50(6):359-61. DOI: 10.1093/tropej/50.6.359. View