Allergic Bronchopulmonary Aspergillosis Progression to Chronic Pulmonary Aspergillosis

2021 ◽  
Vol 30 (1) ◽  
Author(s):  
Aditi Tayal ◽  
John N. Greene
Keyword(s):  
Allergic Bronchopulmonary Aspergillosis ◽  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis

scholarly journals Prospective Evaluation of a New Aspergillus IgG Enzyme Immunoassay Kit for Diagnosis of Chronic and Allergic Pulmonary Aspergillosis

2016 ◽  
Vol 54 (5) ◽  
pp. 1236-1242 ◽  
Author(s):  
C. Dumollard ◽  
S. Bailly ◽  
S. Perriot ◽  
M. P. Brenier-Pinchart ◽  
C. Saint-Raymond ◽  
...  
Keyword(s):  
Enzyme Immunoassay ◽  
Operating Characteristic ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Roc Curves ◽  
Serum Samples ◽  
Prospective Multicenter Study ◽  
Pulmonary Aspergillosis ◽  
Content Type ◽  
Chronic Pulmonary Aspergillosis ◽  
Commercial Enzyme Immunoassay

Anti-AspergillusIgG antibodies are important biomarkers for the diagnosis of chronic pulmonary aspergillosis (CPA) and allergic bronchopulmonary aspergillosis (ABPA). We compared the performance of a new commercial enzyme immunoassay (EIA) (Bordier Affinity Products) with that of the Bio-Rad and Virion\Serion EIAs. This assay is novel in its association of two recombinant antigens with somatic and metabolic antigens ofAspergillus fumigatus. In a prospective multicenter study, 436 serum samples from 147 patients diagnosed with CPA (136 samples/104 patients) or ABPA (94 samples/43 patients) and from 205 controls (206 samples) were tested. We obtained sensitivities of 97%, 91.7%, and 86.1%, and specificities of 90.3%, 91.3%, and 81.5% for the Bordier, Bio-Rad, and Virion\Serion tests, respectively. The Bordier kit was more sensitive than the Bio-Rad kit (P< 0.01), which was itself more sensitive than the Virion\Serion kit (P= 0.04). The Bordier and Bio-Rad kits had similar specificity (P= 0.8), both higher than that of the Virion\Serion kit (P= 0.02). The area under the receiver operating characteristic (ROC) curves confirmed the superiority of the Bordier kit over the Bio-Rad and the Virion\Serion kits (0.977, 0.951, and 0.897, respectively;P< 0.01 for each comparison). In a subset analysis of 279 serum samples tested with the Bordier and Bio-Rad kits and an in-house immunoprecipitin assay (IPD), the Bordier kit had the highest sensitivity (97.7%), but the IPD tended to be more specific (71.2 and 84.7%, respectively;P= 0.10). The use of recombinant, somatic, and metabolic antigens in a single EIA improved the balance of sensitivity and specificity, resulting in an assay highly suitable for use in the diagnosis of chronic and allergic aspergillosis.

scholarly journals Underlying Conditions and Clinical Spectrum of Chronic Pulmonary Aspergillosis (CPA): An Experience from a Tertiary Care Hospital in Karachi, Pakistan

2020 ◽  
Vol 6 (2) ◽  
pp. 41 ◽  
Author(s):  
Nousheen Iqbal ◽  
Muhammad Irfan ◽  
Ammar Mushtaq ◽  
Kauser Jabeen
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Retrospective Chart Review ◽  
Clinical Spectrum ◽  
Care Hospital ◽  
Pulmonary Aspergillosis ◽  
Specific Immunoglobulin ◽  
Chronic Pulmonary Aspergillosis ◽  
Review Study

The incidence of chronic pulmonary aspergillosis (CPA) is especially increasing in high tuberculosis (TB) burden countries. Despite a high estimated CPA burden in Pakistan, actual data on CPA are not available. The aim of the current study is to determine the underlying conditions and clinical spectrum of CPA at a tertiary care hospital in Karachi, Pakistan. This is a retrospective chart review study in patients admitted with CPA from January 2012 to December 2017. A total of 67 patients were identified during the study period. Mean age of CPA patients was 45.9 ± 15 years, 44 (65.7%) were male and 19 (28.4%) had diabetes. The most common type of CPA was simple aspergilloma (49.2%) followed by chronic cavitary pulmonary aspergillosis (CCPA) (44.7%). TB was the underlying cause of CPA in 58 (86.6%) patients followed by bronchiectasis caused by allergic bronchopulmonary aspergillosis (ABPA) 8 (11.9%). Aspergillus flavus was identified in 17 (47.2%), followed by A. fumigatus in 13 (36.1%) CPA patients. Isolation of multiple Aspergillus species was found in 10 (25.6%) patients. Itraconazole was given in 27 (40.3%) patients and a combination therapy of itraconazole and surgery was given in 21 (31.34%) patients. We found aspergilloma and CCPA as the most prevalent forms of CPA in our setting. Further large prospective studies using Aspergillus specific immunoglobulin G (IgG) antibodies testing are required for better understanding of CPA in Pakistan.

scholarly journals Fatal Case of Chronic Pulmonary Aspergillosis and Tuberculosis: A Case Report from an University Hospital in Colombia

2020 ◽  
Author(s):  
Carlos Andres Celis-Preciado ◽  
July Torres-González ◽  
Lina Arbelaez-Collazos ◽  
Camila Betancur-Palacio ◽  
Óscar David Lucero Pantoja
Keyword(s):  
Soft Tissues ◽  
Fatal Case ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Left Lung ◽  
Middle Lobe ◽  
University Hospital ◽  
Pulmonary Aspergillosis ◽  
Pleural Thickening ◽  
Chronic Respiratory Diseases ◽  
Chronic Pulmonary Aspergillosis

Abstract BackgroundThe term aspergillosis from a clinical point of view includes allergic bronchopulmonary aspergillosis, invasive forms of the airway, cutaneous and extrapulmonary aspergillosis and finally chronic non-invasive or semi-invasive pulmonary forms. All of them produced by different species of Aspergillus. In addition, the presentation of aspergillosis together with tuberculosis are rare in scientific literature. We report a case of Chronic pulmonary aspergillosis and tuberculosis in a 72-year-old man Case presentation The patient is a 72-year-old man who was admitted with a 2-year history of constitutional syndrome, dry cough and moderate exertion dyspnea. Chest X-ray showed a rounded mass in the upper lobe of the left lung surrounded by radiolucent areas that suggest cavitations. Computed tomography with chest contrast revealed "tree in bud" pattern in the upper right and middle lobe and lesions of a cystic appearance with the presence of multiple masses with a density of soft tissues. Bronchioalveolar lavage analyses demonstrate Aspergillus fumigatusConclusionsChronic cavity aspergillosis is an uncommon form characterized by cavitation, fibrosis and pleural thickening seen in immunocompetent or mildly immunocompromised patients with chronic respiratory diseases, especially TB.

scholarly journals Misdiagnosis of chronic pulmonary aspergillosis as pulmonary tuberculosis at a tertiary care center in Uganda: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Richard Kwizera ◽  
Andrew Katende ◽  
Felix Bongomin ◽  
Lydia Nakiyingi ◽  
Bruce J. Kirenga
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Outcomes ◽  
Diagnostic Criteria ◽  
Tertiary Care ◽  
Chest Imaging ◽  
Resource Limited Settings ◽  
Pulmonary Aspergillosis ◽  
Resource Limited ◽  
Chronic Pulmonary Aspergillosis ◽  
Hiv Negative

Abstract Background Diagnosis of chronic pulmonary aspergillosis (CPA) is based on a combination of clinical symptomatology, compatible chest imaging findings, evidence of Aspergillus infection and exclusion of alternative diagnosis, all occurring for more than 3 months. Recently, a rapid, highly sensitive and specific point-of-care lateral flow device (LFD) has been introduced for the detection of Aspergillus-specific immunoglobulin (Ig)G, especially in resource-limited settings where CPA is underdiagnosed and often misdiagnosed as smear-negative pulmonary tuberculosis (PTB). Therefore, in our setting, where tuberculosis (TB) is endemic, exclusion of PTB is an important first step to the diagnosis of CPA. We used the recently published CPA diagnostic criteria for resource-limited settings to identify patients with CPA in our center. Case presentation Three Ugandan women (45/human immunodeficiency virus (HIV) negative, 53/HIV infected and 18/HIV negative), with a longstanding history of cough, chest pain, weight loss and constitutional symptoms, were clinically and radiologically diagnosed with PTB and empirically treated with an anti-tuberculous regimen despite negative microbiological tests. Repeat sputum Mycobacteria GeneXpert assays were negative for all three patients. On further evaluation, all three patients met the CPA diagnostic criteria with demonstrable thick-walled cavities and fungal balls (aspergilomas) on chest imaging and positive Aspergillus-specific IgG/IgM antibody tests. After CPA diagnosis, anti-TB drugs were safely discontinued for all patients, and they were initiated on capsules of itraconazole 200 mg twice daily with good treatment outcomes. Conclusions The availability of simple clinical diagnostic criteria for CPA and a LFD have the potential to reduce misdiagnosis of CPA and in turn improve treatment outcomes in resource-limited settings.

scholarly journals Performance of LDBio Aspergillus WB and ICT Antibody Detection in Chronic Pulmonary Aspergillosis

2021 ◽  
Vol 7 (4) ◽  
pp. 311
Author(s):  
Anna Rozaliyani ◽  
Findra Setianingrum ◽  
Sresta Azahra ◽  
Asriyani Abdullah ◽  
Ayu Eka Fatril ◽  
...  
Keyword(s):  
Receiver Operating Curve ◽  
Antibody Detection ◽  
Pulmonary Aspergillosis ◽  
Comparative Performance ◽  
Tuberculosis Patients ◽  
Chronic Pulmonary Aspergillosis ◽  
Screening Assays ◽  
Roc Area ◽  
Flow Detection ◽  
Sensitivity Specificity

The detection of Aspergillus antibody has a key role in the diagnosis of chronic pulmonary aspergillosis. Western blot (WB) and immunochromatography (ICT) lateral flow detection of Aspergillus antibody can be used as confirmatory and screening assays but their comparative performance in TB patients is not known. This study investigated the performance of these assays among 88 post-tuberculosis patients with suspected CPA. Sensitivity, specificity, receiver operating curve (ROC), area under-curve (AUC) and the agreement between two assays were evaluated. Both WB and ICT showed good sensitivity (80% and 85%, respectively) for detection of Aspergillus antibodies. Substantial agreement (0.716) between these assays was also obtained. The highest AUC result (0.804) was achieved with the combination of WB and ICT. The global intensity of WB correlated with the severity of symptoms in CPA group (p = 0.001). The combination of WB and ICT may increase specificity in CPA diagnosis.

Sign in / Sign up

Export Citation Format

Share Document