Management of allergic bronchopulmonary aspergillosis: a review and update

Mahdavinia, Mahboobeh; Grammer, Leslie C.

doi:10.1177/1753465812443094

Cited by 37 publications

(36 citation statements)

References 94 publications

(169 reference statements)

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“…One earlier study showed that the median time to recovery was 6 d (1-14) for peak expiratory flow rate (PEFR) and 7d (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) for symptoms, but recovery of PEFR to baseline values was complete in only 75.2% of exacerbations at 35d [34]. In our study, 18% (51/273) of the COPD patients were enrolled within 2~4 weeks after an exacerbation, when the lung functions were still recovering at least in some of the patients.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Increased Serum IgE and Aspergillus Sensitization in Patients With COPD and Their Association With Symptoms and Lung Function

Jin

Liu

2016

Chest

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Background: Allergy and Aspergillus hypersensitivity (AH) were shown to be associated with severe symptoms or worse lung function in COPD patients. The prevalence of elevated total IgE (T-IgE) and its association with clinical symptoms and lung function in COPD have not been studied. The prevalence of AH and its correlation with clinical characteristics in a COPD cohort of larger sample size is also lacking. Methods: 273 patients with COPD were evaluated by respiratory symptoms, blood test, chest HRCT, lung function, serum detection of T-IgE and Aspergillus specific IgE. Patients with T-IgE ≥ 1000 KU/L were further investigated for allergic bronchopulmonary aspergillosis (ABPA). Results: The prevalence of elevated T-IgE and AH in patients with COPD was 47.3% and 15.0%, respectively. Eight patients (2.9%) met the diagnostic criteria for ABPA. Compared with the normal T-IgE group, patients with elevated T-IgE had a longer history of dyspnea (p < 0.01), an earlier onset of dyspnea after chronic cough/expectoration (p < 0.01), and were more likely to wheeze (p < 0.01). They also showed worse lung functions and more severe GOLD staging (p < 0.01). Analysis of the clinical data in male patients with smoking as the risk factor showed the same results. To evaluate the clinical characteristics of COPD with AH, patients with elevated T-IgE were further divided into subgroups with and without AH. When compared with the normal T-IgE group, both the two subgroups showed longer history of dyspnea (p < 0.01), an earlier onset of dyspnea (p < 0.01) and a worse status of lung function (p < 0.05). Correlation analysis demonstrated that T-IgE was correlated positively with the time length of dyspnea (r = 0.401, p < 0.001), and the ratio of duration of dyspnea to that of chronic cough/expectoration (r = 0.59, p < 0.001), but negatively with FEV1/ FVC% (r = −0.194, p = 0.001), and FEV1%predicted (r = −0.219, p < 0.001).

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Section: Discussionmentioning

confidence: 99%

The Prevalence of Increased Serum IgE and Aspergillus Sensitization in Patients With COPD and Their Association With Symptoms and Lung Function

Jin

Liu

2016

Chest

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“…The diagnosis of bronchiectasis on chest HRCT was made if bronchial wall thickening was present with the ratio of the diameter of bronchus to that of the accompanying pulmonary artery being more than 1.1 (signet ring sign), or the lack of tapering of bronchi (tramline sign). Central bronchiectasis was defined as the presence of bronchiectasis in the central two thirds of the lung field [13,14]. …”

Section: Methodsmentioning

confidence: 99%

The prevalence of increased serum IgE and Aspergillus sensitization in patients with COPD and their association with symptoms and lung function

2014

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BackgroundAllergy and Aspergillus hypersensitivity (AH) were shown to be associated with severe symptoms or worse lung function in COPD patients. The prevalence of elevated total IgE (T-IgE) and its association with clinical symptoms and lung function in COPD have not been studied. The prevalence of AH and its correlation with clinical characteristics in a COPD cohort of larger sample size is also lacking.Methods273 patients with COPD were evaluated by respiratory symptoms, blood test, chest HRCT, lung function, serum detection of T-IgE and Aspergillus specific IgE. Patients with T-IgE ≥ 1000 KU/L were further investigated for allergic bronchopulmonary aspergillosis (ABPA).ResultsThe prevalence of elevated T-IgE and AH in patients with COPD was 47.3% and 15.0%, respectively. Eight patients (2.9%) met the diagnostic criteria for ABPA. Compared with the normal T-IgE group, patients with elevated T-IgE had a longer history of dyspnea (p < 0.01), an earlier onset of dyspnea after chronic cough/expectoration (p < 0.01), and were more likely to wheeze (p < 0.01). They also showed worse lung functions and more severe GOLD staging (p < 0.01). Analysis of the clinical data in male patients with smoking as the risk factor showed the same results. To evaluate the clinical characteristics of COPD with AH, patients with elevated T-IgE were further divided into subgroups with and without AH. When compared with the normal T-IgE group, both the two subgroups showed longer history of dyspnea (p < 0.01), an earlier onset of dyspnea (p < 0.01) and a worse status of lung function (p < 0.05). Correlation analysis demonstrated that T-IgE was correlated positively with the time length of dyspnea (r = 0.401, p < 0.001), and the ratio of duration of dyspnea to that of chronic cough/expectoration (r = 0.59, p < 0.001), but negatively with FEV1/FVC% (r = −0.194, p = 0.001), and FEV1%predicted (r = −0.219, p < 0.001).ConclusionsThere was a high prevalence of elevated serum T-IgE and AH in patients with COPD. Serum T-IgE level was correlated with symptoms such as dyspnea and impairment of lung function. Allergens other than Aspergillus may have similar effects on disease expression or progression of COPD.

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“…BPA is known to occur in chronic cavities in patients with mild immune compromise and lung damage [34,32]. It has been shown that BPA is a relatively common association with severe asthma [47,33]. ABPA, occurring almost exclusively in asthma patients, is characterized radiographically by fleeting pulmonary alveolar opacities caused by deposition of immune complexes and inflammatory cells within the lung parenchyma.…”

Section: Discussionmentioning

confidence: 99%

Reliable quantitative score for grading chest X-ray using the dynamic of blood cell count in adult asthma

Haffor¹,

Dahan

Ismaeel³

2015

Egyptian Journal of Chest Diseases and Tuberculosis

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The purpose of the present study was to rate the level of spread of asthma-induced bronchial morphological changes on chest X-ray (CXR), using the modified Shwachman-Kulczycki (S-K) rating scale as predicted by the dynamic of blood cell count (CBC). A sample of 40 asthma patients' records was classified into 4 groups based on their clinical presentations and frequency of their visits to the hospital; Group-1 62 visits per week with reversible symptoms, Group-2 P2 visits per week with irreversible symptoms, Group-3: P3-4 visits per week with irreversible symptoms; Group-4: patients with severe shortness of breath in whom SaO 2 was threatening, hence were admitted as inpatients. Patients' CXR were scored based on the modified Shwachman-Kulczycki (S-K) scale rating. Blood analysis showed that RBC and their indices (HCT, HGB, MCH, RDW) were highest in group-2. White blood cells and their derivatives (NEU, EOS and LYM) were highest in group 4. CXR for group-2 showed bilateral increased bronchovascular markings but normal both lung fields and ruled out for costo-phrenic angles type of fever. Chest X-ray for group-3 showed hyperinflation, perihilar marking associated with bronchial thickening and unfolding aorta. In patients in group-4 development of broncho-pneumonic infiltration type of SOB and some evidence of bronchial edema with significant (p < 0.05) elevation in WBC were observed. The regression of S-K score on the dynamic of some CBC parameters was significant (p < 0.05). The best subsets that describe the model were:S-K ¼ 14:242 þ b1 NEUðÀ1:28Þ þ b2 EOSðÀ10:929Þ þ b3 HCTð0:577Þ þ b4 HGBðÀ:898Þ þ b5 RDWð0:546Þ þ b6 RBCðÀ1:966Þ þ e

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Management of allergic bronchopulmonary aspergillosis: a review and update

Cited by 37 publications

References 94 publications

The Prevalence of Increased Serum IgE and Aspergillus Sensitization in Patients With COPD and Their Association With Symptoms and Lung Function

The Prevalence of Increased Serum IgE and Aspergillus Sensitization in Patients With COPD and Their Association With Symptoms and Lung Function

The prevalence of increased serum IgE and Aspergillus sensitization in patients with COPD and their association with symptoms and lung function

Reliable quantitative score for grading chest X-ray using the dynamic of blood cell count in adult asthma

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