Prevalência de aspergilose broncopulmonar alérgica em pacientes com fibrose cística na Bahia, Brasil

Carneiro, Ana Cláudia Costa; Lemos, Antônio Carlos Moreira; Arruda, Sérgio; Santana, Maria Angélica

doi:10.1590/s1806-37132008001100003

Cited by 14 publications

(5 citation statements)

References 27 publications

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“…Geller et al also found 66% sensitization to AF in 51 adult patients with CF ( 18 ). Similar to our results, Carneiro et al found 26% positive reaction to AF in 74 Brazilian patients with CF ( 19 ). A recent meta-analysis study reported the prevalence of positive skin test to AF from 20% to 65% in patients with CF, with a pooled prevalence of 39.1% ( 8 ).…”

Section: Discussionsupporting

confidence: 92%

Allergic bronchopulmonary aspergillosis in patients with cystic fibrosis and non-cystic fibrosis bronchiectasis

et al. 2018

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BackgroundAspergillus 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.ObjectiveThe aim of this study was to determine the frequency of AS and ABPA in patients with CF and non-CF bronchiectasis in southwestern Iran.MethodsThis 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.ResultsNine 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.ConclusionABPA 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.

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Section: Discussionsupporting

confidence: 92%

Allergic bronchopulmonary aspergillosis in patients with cystic fibrosis and non-cystic fibrosis bronchiectasis

et al. 2018

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“… 18 ABPA has been described more often in adolescents and adults with CF, as indicated by studies that show median age of 14.7 and 18 years of age. 19 , 20 In the present study, as median age was 8 years old, it is possible that subjects were still developing sensitization to A. fumigatus ; therefore, with age, they might develop ABPA.…”

Section: Discussionmentioning

confidence: 70%

Exames Para Avaliar a Sensibilização Ao Aspergillus Fumigatus Em Fibrose Cística

Aguiar

Damaceno

Forte³

2017

Rev. paul. pediatr.

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Objective: To evaluate the results of the tests used to identify the IgE mediated sensitization to Aspergillus fumigatus in patients with cystic fibrosis.Methods: This is a cross-sectional descriptive study with a convenience sample of 86 patients diagnosed with cystic fibrosis in the Reference Service in Cystic Fibrosis at a tertiary teaching hospital. The following tests were performed to assess the sensitization to A. fumigatus in patients with cystic fibrosis: Total serum IgE, eosinophil count, fungus detection through oropharyngeal swab or sputum culture, serum-specific IgE, and immediate-type hypersensitivity (IgE) skin tests. We compared the results of the different tests performed.Results: In 33 (38.4%) patients with cystic fibrosis, with ages ranging from 1 to 33 years (median of 8 years), the IgE-mediated A. fumigatus sensitization test results were: in 16 patients, there was an increase in serum-specific IgE (>0.35 kU/L); in 23, skin tests were positive; and six had sensitization in both tests. We observed two patients with eosinophilia (>1,000 eosinophils/mm3) and seven with increasing total serum IgE (>1,000 IU/mL), all of whom obtained negative results in skin tests and had no IgE increase specific to A. fumigatus. A. fumigatus was not detected in oropharyngeal swabs and/or sputum culture of any patients.Conclusions: We conclude that, among the tests used to assess sensitization to A. fumigatus in cystic fibrosis patients, both serum-specific IgE and immediate-type hypersensitivity (IgE) skin tests are required. Serum eosinophilia and respiratory secretion culture were not essential in this study.

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“…Brazil only had 15 individuals diagnosed with ABPA in 2010 out of the total 1,555 patients [25], again much lower than our estimate of 56 in the adult population. Amongst 74 individuals with CF in Bahia, Brazil, 2 (2.7%) were diagnosed with ABPA [38]. This study recognised the need to monitor these patients for ABPA as many were sensitised to A. fumigatus .…”

Section: Resultsmentioning

confidence: 83%

Multi-Country Estimate of Different Manifestations of Aspergillosis in Cystic Fibrosis

2014

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Aspergillus spp. can lead to allergic bronchopulmonary aspergillosis (ABPA), Aspergillus sensitisation and Aspergillus bronchitis in CF. The relative frequencies of these entities have recently been ascertained in a large UK adult CF cohort. We have used this data to estimate the burden of aspergillosis and ABPA cases in adult CF patients in 30 countries reporting CF. National and international CF registry data was accessed and assessed for completeness and age distribution. Published proportions of ABPA (17.7%), Aspergillus sensitisation (14.6%) and Aspergillus bronchitis (30%) in CF were applied to those >18 years and compared with notified ABPA cases. Of the 76,201 estimated CF patients worldwide (not including India), 37,714 were >18 years. The proportion of adults to children varied from 63% in Norway to 20% in Brazil. ABPA caseload in adults is anticipated to be 6,675 cases of which only 2,221 cases (33%) are currently recorded, indicating substantial underdiagnosis. The ABPA diagnosis rate compared with estimated rates varies by country from 101% (France) to 14.5% (Greece), although genetic variation could account for genuine differences compared with the UK. Aspergillus bronchitis is not currently recognised or recorded in CF registries but there are an anticipated 10,988 adult cases. Aspergillus sensitisation, associated with increased bronchiectasis and reduced FEV1, affects an anticipated 5,506 patients without ABPA or Aspergillus bronchitis. Together ABPA and Aspergillus bronchitis are estimated to affect 17,989 adults, 47.7% of the adult CF population. ABPA also occurs in children and teenagers and 984 cases were documented in registries. Diagnosed ABPA rates by age were available for the ECFS registry, USA, UK, Ireland, Belgium and Netherlands. The rate was <1% under 4 years, and increased throughout childhood and adolescence, with marked variation between countries. Newly published diagnostic criteria and methods should facilitate better recognition of aspergillosis in CF, allowing better CF disease control.

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Prevalência de aspergilose broncopulmonar alérgica em pacientes com fibrose cística na Bahia, Brasil

Cited by 14 publications

References 27 publications

Allergic bronchopulmonary aspergillosis in patients with cystic fibrosis and non-cystic fibrosis bronchiectasis

Allergic bronchopulmonary aspergillosis in patients with cystic fibrosis and non-cystic fibrosis bronchiectasis

Exames Para Avaliar a Sensibilização Ao Aspergillus Fumigatus Em Fibrose Cística

Multi-Country Estimate of Different Manifestations of Aspergillosis in Cystic Fibrosis

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