Allergic bronchopulmonary Aspergillosis in children

Abstract

Background/aim: Allergic Bronchopulmonary Aspergillus (ABPA) is a lung disease caused by hypersensitivity from Aspergillus fumigatus. Diagnostic criteria, staging systems and treatment methods for ABPA disease have been reported in studies evaluating populations, the majority of which are adult patients. Our study aimed to discuss the use of ABPA diagnostic criteria in children, the success of other alternative regimens to oral corticosteroids in the treatment of ABPA, and the changes that occur during treatment, in the light of the literature. Materials and methods:Between January 2017 and 2020, patients diagnosed with ABPA at the Dokuz Eylul University Child Allergy and Immunology clinic were identified; demographic characteristics, clinical and laboratory findings, diagnostic scores and stages, treatment protocols were analyzed retrospectively. Results:The mean age of patients diagnosed with ABPA was 14.33±1.96. At the time of ABPA diagnosis, the median Total IgE level was 1033 IU/mL (1004-6129), and the median AF specific IgE was 10.64 (2.59-49.70) kU/L. Bronchiectasis was detected in HRCT of 5 cases. We detected significant improvement in spirometric analysis with omalizumab treatment in our patient with steroid-related complications. Conclusion:Today, although risk factors have been investigated for ABPA, it has not been revealed clearly. Both diagnostic criteria and treatment regimens have been described in research studies, mostly adults. In pediatric patients; clarification of diagnosis and treatment algorithms is necessary to prevent irreversible lung tissue damage and possible drug side effects.

Aspergillus sensitization associated with current asthma in children in the United States: an analysis of data from the 2005-2006 NHANES

“…The diagnostic criteria of ABPA are: (1) the presence of asthma, cystic fibrosis, or chronic obstructive pulmonary disease, (2) proximal bronchiectasis positive, (3) AF skin prick test positive or AF sIgE > 0.35 IU/mL, and (4) total serum IgE > 417 IU/mL[16]. In our study, the prevalence of Aspergillus…”

“…Patients who still have poorly controlled asthma after receiving conventional treatment for asthma and are sensitized to Aspergillus should be suspected of having ABPA. The diagnostic criteria of ABPA are: (1) the presence of asthma, cystic fibrosis, or chronic obstructive pulmonary disease; (2) positive results for proximal bronchiectasis; (3) a positive AF skin prick test or AF sIgE >0.35 IU/mL; and (4) total serum IgE >417 IU/mL [ 16 ]. In our study, the prevalence of Aspergillus sIgE >0.35 IU/mL and total IgE >417 IU/mL was 9.4% (n=15) in the current asthma group.…”