Global burden of allergic bronchopulmonary aspergillosis with asthma and its complication chronic pulmonary aspergillosis in adults

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.

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

Journal of Fungi ◽

10.3390/jof6020041 ◽

2020 ◽

Vol 6 (2) ◽

pp. 41 ◽

Cited By ~ 3

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.

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Allergic Bronchopulmonary Aspergillosis Progression to Chronic Pulmonary Aspergillosis

Infectious Diseases in Clinical Practice ◽

10.1097/ipc.0000000000001069 ◽

2021 ◽

Vol 30 (1) ◽

Author(s):

Aditi Tayal ◽

John N. Greene

Keyword(s):

Allergic Bronchopulmonary Aspergillosis ◽

Pulmonary Aspergillosis ◽

Chronic Pulmonary Aspergillosis

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

10.21203/rs.3.rs-96908/v1 ◽

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.

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