Aspergilloma in Sarcoid and Tuberculosis

Tomlinson, James R.; Sahn, Steven A.

doi:10.1378/chest.92.3.505

Cited by 101 publications

(60 citation statements)

References 18 publications

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“…The time-frames of observation of sarcoidosis varied substantially, and one small study from the USA indicated that most patients with pulmonary sarcoidosis complicated by CPA had died after 2 yrs [12]. However, this is not our experience and most of our patients with CPA complicating sarcoidosis are alive and stable o5 yrs after diagnosis.…”

Section: Handling Attrition Among Cpa Casesmentioning

confidence: 92%

“…Antifungal therapy is effective in ameliorating symptoms and reducing recurrence of haemoptysis in .60% of patients [4][5][6][7][8][9][10], and may reduce progressive lung fibrosis. Overall, treated CPA has a 20-33% short-term mortality and a 50% mortality over 5 yrs [6,11], but one small cohort showed that almost all patients with sarcoidosis and CPA had died within 2 yrs [12].…”

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confidence: 99%

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Global burden of chronic pulmonary aspergillosis complicating sarcoidosis

Pleuvry²,

2012

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Chronic pulmonary aspergillosis (CPA) may complicate pulmonary sarcoidosis. We re-estimated the global burden of sarcoidosis and the burden of CPA complicating sarcoidosis.We searched the literature and reference lists of retrieved papers to identify all published sarcoidosis incidence and prevalence data. We estimated the frequency of CPA from 11 papers relating to .3,000 patients with sarcoidosis to derive CPA patient numbers. We applied an annual attrition rate of 15% (range 10-25%) to estimate the global burden of CPA.We estimate that the annual incidence of sarcoidosis is 344,000 patients worldwide and the prevalence is ,1,238,000 cases, distributed as follows: 165,979 in Europe, 224,000 in the Americas, 492,892 in Africa, 80,023 in the Eastern Mediterranean, 41,660 in the West Pacific and 234,010 in Southeast Asia. CPA complicates sarcoidosis in 3-12% of cases. Using a 6% frequency, we estimate a global burden of 71,907 (range 35,954-143,815 (3-12%)) CPA cases complicating sarcoidosis, with 24% and 37% of cases estimated to be present in the Americas and Africa, because of the higher incidence of sarcoidosis in black people.As CPA responds to long-term antifungal therapy, which may prevent life-threatening haemoptysis, screening periodically for CPA in those with pulmonary sarcoidosis may be important, especially in patients requiring corticosteroid therapy.

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Section: Handling Attrition Among Cpa Casesmentioning

confidence: 92%

mentioning

confidence: 99%

Global burden of chronic pulmonary aspergillosis complicating sarcoidosis

Pleuvry²,

2012

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“…The case fatality rate after admission to hospital ranges from 10% to 30%. 6,8,10 We have therefore introduced an annual attrition rate of 15% by default, with a range from 10% to 25%, when converting annual incident cases to five-year period prevalence. In our experience, survival is determined primarily by the combined effect of the severity of the underlying pulmonary disease and the extent and pace of lung destruction.…”

Section: Accounting For Cpa-related Mortalitymentioning

confidence: 99%

“…[4][5][6] Of the long-term sequelae of PTB, CPA is perhaps the most subtle, yet the most severe. [4][5][6][7][8][9][10][11] In the 1960s the Research Committee of the British Thoracic and Tuberculosis Association estimated the prevalence of CPA in patients who had a residual cavity of at least 2.5 cm on the chest radiograph following treatment for PTB. 9,12 It assessed more than 500 patients from 55 chest clinics twice -once about 12 months after the sputum became negative for acid fast bacilli, 12 and again three years later.…”

Section: Introductionmentioning

confidence: 99%

Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosis

Denning¹,

Pleuvry²,

Cole³

2011

Bull World Health Org

348

366

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“…(15) Testing for serum precipitins to A. fumigatus might be useful in screening to determine which patients are at risk for developing an aspergilloma. In the only review in which TB patients and sarcoidosis patients (14 cases each) were compared in terms of aspergilloma formation, (16) the authors found that the clinical presentation was similar in the two groups. However, the radiographic profile was strikingly different: localized disease was seen in 12 of the 14 patients with TB; and diffuse disease was seen in 13 of the 14 with sarcoidosis.…”

Section: Discussionmentioning

confidence: 99%

Aspergilloma formation in cavitary sarcoidosis

2009

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Pulmonary cavitation is rather uncommon in patients with sarcoidosis, and aspergilloma is even more uncommon in such cases. Here, we present the case of a 63-year-old female patient with cavitary lung disease who had been under treatment for TB for 9 months. A diagnosis of pulmonary sarcoidosis was established based on the fiberoptic bronchoscopy finding of noncaseating granuloma. Treatment with corticosteroids led to a dramatic improvement in symptoms. While under treatment for sarcoidosis, the patient developed an aspergilloma. She presented immediate skin test reactivity to Aspergillus fumigatus, as well as positivity for A. fumigatus serum precipitins. This is the first reported case of aspergilloma formation in a patient with cavitary sarcoidosis in India.Keywords: Sarcoidosis, pulmonary; Aspergillosis; Medical records. ResumoA cavitação pulmonar é rara em pacientes com sarcoidose, e o aspergiloma é ainda mais raro nestes casos. Apresentamos o caso de uma paciente de 63 anos com doença pulmonar cavitária em tratamento para a TB por 9 meses. Estabeleceu-se o diagnóstico de sarcoidose pulmonar com base nos achados de granuloma não-caseoso na fibrobroncoscopia. Houve grande melhora dos sintomas com o tratamento com corticosteroides. A paciente desenvolveu um aspergiloma durante o tratamento para a sarcoidose. Houve reação imediata ao teste cutâneo para Aspergillus fumigatus, assim como resultado positivo para precipitinas de A. fumigatus no soro. Este é o primeiro caso relatado de formação de aspergiloma em um paciente com sarcoidose com cavitação na Índia.

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Aspergilloma in Sarcoid and Tuberculosis

Cited by 101 publications

References 18 publications

Global burden of chronic pulmonary aspergillosis complicating sarcoidosis

Global burden of chronic pulmonary aspergillosis complicating sarcoidosis

Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosis

Aspergilloma formation in cavitary sarcoidosis

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