scholarly journals Role of the Aspergillus-Specific IgG and IgM Test in the Diagnosis and Follow-Up of Chronic Pulmonary Aspergillosis

2019 ◽  
Vol 10 ◽  
Author(s):  
Hongxing Li ◽  
Yuwen Rui ◽  
Wei Zhou ◽  
Lulu Liu ◽  
Binchan He ◽  
...  
Keyword(s):  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis ◽  
Specific Igg

scholarly journals Long-term follow-up: tuberculosis, bronchiectasis and chronic pulmonary aspergillosis

Pneumologia ◽  
2019 ◽  
Vol 68 (3) ◽  
pp. 138-143
Author(s):  
Oxana Munteanu ◽  
Dumitru Chesov ◽  
Doina Rusu ◽  
Irina Volosciuc ◽  
Victor Botnaru
Keyword(s):  
Past History ◽  
Natural Evolution ◽  
Pulmonary Aspergillosis ◽  
Long Term Follow Up ◽  
History Of ◽  
Chronic Pulmonary Aspergillosis ◽  
The Impact

Abstract Pulmonary sequelae related to tuberculosis (TB) are among the major causes of bronchiectasis in Eastern Europe. The role of bacterial colonisation in the pathogenesis of bronchiectasis has been continuously studied over the last decades, less understood remains the impact of fungal infection, alone or in association with bacterial. Although the data on the development of chronic pulmonary aspergillosis (CPA) secondary to TB are scarce, recent evidence suggests a higher prevalence of CPA in patients with a past history of pulmonary TB than it was previously estimated. We present a case of natural evolution of CPA, with a radiological follow-up, in a patient with post-tuberculous bronchiectasis.

scholarly journals Long-term follow-up: tuberculosis, bronchiectasis and chronic pulmonary aspergillosis

Pneumologia ◽  
2019 ◽  
Vol 68 (3) ◽  
pp. 138-143
Author(s):  
Oxana Munteanu ◽  
Dumitru Chesov ◽  
Doina Rusu ◽  
Irina Volosciuc ◽  
Victor Botnaru
Keyword(s):  
Past History ◽  
Natural Evolution ◽  
Pulmonary Aspergillosis ◽  
Long Term Follow Up ◽  
History Of ◽  
Chronic Pulmonary Aspergillosis ◽  
The Impact

Abstract Pulmonary sequelae related to tuberculosis (TB) are among the major causes of bronchiectasis in Eastern Europe. The role of bacterial colonisation in the pathogenesis of bronchiectasis has been continuously studied over the last decades, less understood remains the impact of fungal infection, alone or in association with bacterial. Although the data on the development of chronic pulmonary aspergillosis (CPA) secondary to TB are scarce, recent evidence suggests a higher prevalence of CPA in patients with a past history of pulmonary TB than it was previously estimated. We present a case of natural evolution of CPA, with a radiological follow-up, in a patient with post-tuberculous bronchiectasis.

scholarly journals A rare association of Kimura’s disease with chronic pulmonary aspergillosis

2018 ◽  
Vol 6 (5) ◽  
pp. 1821
Author(s):  
Laxma Reddy S. ◽  
Bhaskar K. ◽  
Vara Prasad K. ◽  
Paramjyothi G. K.
Keyword(s):  
Ulcerative Colitis ◽  
Medical Literature ◽  
Kimura’S Disease ◽  
Inflammatory Condition ◽  
Pulmonary Aspergillosis ◽  
Aortitis Syndrome ◽  
Rare Association ◽  
Chronic Pulmonary Aspergillosis

Kimura’s disease is a rare chronic benign inflammatory condition characterised by nodules of skin and soft tissue and lymphnodes. Eosinophilic infiltration is a prominent finding. It has been reported in association with various conditions like nephrotic syndrome, bronchial asthma, ulcerative colitis and aortitis syndrome. Hereby we present a case in medical literature to the best of our knowledge in Kimura’s disease in association with chronic cavitary pulmonary aspergillosis, which has never been reported. He was treated with antifungals, after which he responded clinically, eosinophilia has subsided and he is under regular follow up. Now This case report suggest possible role of chronic aspergillosis as a cause for Kimura’s disease.

scholarly journals Incidence and Risk Factors of Chronic Pulmonary Aspergillosis Development during Long-Term Follow-Up after Lung Cancer Surgery

2020 ◽  
Vol 6 (4) ◽  
pp. 271
Author(s):  
Sun Shin ◽  
Bo-Guen Kim ◽  
Jiyeon Kang ◽  
Sang-Won Um ◽  
Hojoong Kim ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cumulative Incidence ◽  
Lung Cancer Surgery ◽  
Cancer Surgery ◽  
Pulmonary Aspergillosis ◽  
Factors Associated ◽  
Long Term Follow Up ◽  
Chronic Pulmonary Aspergillosis

Lung resection surgery for non-small-cell lung cancer (NSCLC) is reportedly a risk factor for developing chronic pulmonary aspergillosis (CPA). However, limited data are available regarding the development of CPA during long-term follow-up after lung cancer surgery. This study aimed to investigate the cumulative incidence and clinical factors associated with CPA development after lung cancer surgery. We retrospectively analyzed 3423 patients with NSCLC who (1) underwent surgical resection and (2) did not have CPA at the time of surgery between January 2010 and December 2013. The diagnosis of CPA was based on clinical symptoms, serological or microbiological evidences, compatible radiological findings, and exclusion of alternative diagnoses. The cumulative incidence of CPA and overall survival (OS) were estimated using the Kaplan–Meier method, and a multivariable Cox proportional hazard analysis was performed to identify factors associated with CPA development. Patients were followed-up for a median of 5.83 years with a 72.3% 5-year OS rate. Fifty-six patients developed CPA at a median of 2.68 years after surgery, with cumulative incidences of 0.4%, 1.1%, 1.6%, and 3.5% at 1, 3, 5, and 10 years, respectively. Lower body mass index (BMI), smoking, underlying interstitial lung disease, thoracotomy, development of postoperative pulmonary complications 30 days after surgery, and treatment with both chemotherapy and radiotherapy were independently associated with CPA development. The cumulative incidence of CPA after surgery was 3.5% at 10 years and showed a steadily increasing trend during long-term follow-up. Therefore, increased awareness regarding CPA development is needed especially in patients with risk factors.

Impact of high baseline Aspergillus-specific IgG levels on weight and quality-of-life outcomes of patients with chronic pulmonary aspergillosis

2020 ◽  
Vol 58 (7) ◽  
pp. 1000-1004
Author(s):  
Felix Bongomin ◽  
Tomaz Garcez ◽  
David W Denning
Keyword(s):  
Quality Of Life ◽  
Antifungal Treatment ◽  
Weight Changes ◽  
Pulmonary Aspergillosis ◽  
Group A ◽  
Chronic Pulmonary Aspergillosis ◽  
Specific Igg ◽  
Group B ◽  
The Impact

Abstract This study aimed to evaluate the impact of quantitative baseline Aspergillus-specific immunoglobulin G (IgG) serum levels on weight changes of patients with chronic pulmonary aspergillosis (CPA) under antifungal treatment. We retrospectively reviewed data of patients diagnosed with CPA between April 2015 and March 2018 at the National Aspergillosis Centre (Manchester, UK). All patients were on continued antifungal treatment for 12 months. Data on Aspergillus-specific IgG levels, St George's quality of life (SGQoL) variables and weight at baseline, 6 months and 12 months were extracted. We defined a high serum Aspergillus-specific IgG as ≥ 200 mg/l (Group A) and low level < 200 mg/l (Group B). Forty-nine patients (37 male; 12 female), median age 65 years (range: 29–86) were studied. Overall, 33% (n = 16) of the patients were in Group A. The baseline characteristics between the two groups were similar. The median Charlson comorbidity index was 4 (range: 0–5) and 3 (range: 0–9) for Group A and Group B, respectively (P = .543). There was a sustained decline in median Aspergillus IgG levels from baseline, through 6 month to 12 months of continues therapy from 170 (range: 20–1110) to 121 (range: 20–1126), and finally 107 (15–937) mg/l, respectively (P < .001). Group A patients gained more weight at 6 months (9/15 [60%] vs. 7/33 [21%], P = .012) and at 12 months of treatment (9/15 [60%] vs. 7/33 [22%]), and more patients in Group B lost weight ((13/33 [41%] vs. 1/15 [7%]), P = .015). However, there was no difference in QoL outcomes across groups at 6 (P = .3) and 12 (P = .7) months. A very high Aspergillus IgG may confer a higher likelihood of weight gain as a key, objective marker of clinical response, if patients can tolerate 12 months of antifungal therapy.

scholarly journals Chronic pulmonary aspergillosis commonly complicates treated pulmonary tuberculosis with residual cavitation

2019 ◽  
Vol 53 (3) ◽  
pp. 1801184 ◽  
Author(s):  
Iain D. Page ◽  
Rosemary Byanyima ◽  
Sharath Hosmane ◽  
Nathan Onyachi ◽  
Cyprian Opira ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Chest Radiography ◽  
Chronic Cough ◽  
Reasonable Accuracy ◽  
Pulmonary Aspergillosis ◽  
Pulmonary Tb ◽  
Pleural Thickening ◽  
Radiological Features ◽  
Chronic Pulmonary Aspergillosis ◽  
Specific Igg

Chronic pulmonary aspergillosis (CPA) complicates treated pulmonary tuberculosis (TB), with high 5-year mortality. We measured CPA prevalence in this group.398 Ugandans with treated pulmonary TB underwent clinical assessment, chest radiography and Aspergillus-specific IgG measurement. 285 were resurveyed 2 years later, including computed tomography of the thorax in 73 with suspected CPA. CPA was diagnosed in patients without active TB who had raised Aspergillus-specific IgG, radiological features of CPA and chronic cough or haemoptysis.Author-defined CPA was present in 14 (4.9%, 95% CI 2.8–7.9%) resurvey patients. CPA was significantly more common in those with chest radiography cavitation (26% versus 0.8%; p<0.001), but possibly less frequent in HIV co-infected patients (3% versus 6.7%; p=0.177). The annual rate of new CPA development between surveys was 6.5% in those with chest radiography cavitation and 0.2% in those without (p<0.001). Absence of cavitation and pleural thickening on chest radiography had 100% negative predictive value for CPA. The combination of raised Aspergillus-specific IgG, chronic cough or haemoptysis and chest radiography cavitation had 85.7% sensitivity and 99.6% specificity for CPA diagnosis.CPA commonly complicates treated pulmonary TB with residual chest radiography cavitation. Chest radiography alone can exclude CPA. Addition of serology can diagnose CPA with reasonable accuracy.

scholarly journals Evaluation of LDBio Aspergillus ICT Lateral Flow Assay for IgG and IgM Antibody Detection in Chronic Pulmonary Aspergillosis

2019 ◽  
Vol 57 (9) ◽  
Author(s):  
Elizabeth Stucky Hunter ◽  
Malcolm D. Richardson ◽  
David W. Denning
Keyword(s):  
United Kingdom ◽  
Line Intensity ◽  
Test Line ◽  
Lateral Flow ◽  
Lateral Flow Assay ◽  
Antibody Detection ◽  
Resource Constrained ◽  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis ◽  
Specific Igg

ABSTRACT Detecting Aspergillus-specific IgG is critical to diagnosing chronic pulmonary aspergillosis (CPA). Existing assays are often cost- and resource-intensive and not compatible with resource-constrained laboratory settings. LDBio Diagnostics has recently commercialized a lateral flow assay based on immunochromatographic technology (ICT) that detects Aspergillus antibodies (IgG and IgM) in less than 30 min, requiring minimal laboratory equipment. A total of 154 CPA patient sera collected at the National Aspergillosis Centre (Manchester, United Kingdom) and control patient sera from the Peninsula Research Bank (Exeter, United Kingdom) were evaluated. Samples were applied to the LDBio Aspergillus ICT lateral flow assay, and results were read both visually and digitally. Results were compared with Aspergillus IgG titers in CPA patients, measured by ImmunoCAP-specific IgG assays. For proven CPA patients versus controls, sensitivity and specificity for the LDBio Aspergillus ICT were 91.6% and 98.0%, respectively. In contrast, the routinely used ImmunoCAP assay exhibited 80.5% sensitivity for the same cohort (cutoff value, 40 mg of antigen-specific antibodies [mgA]/liter). The assay is easy to perform but challenging to read when only a very faint band is present (5/154 samples tested). The ImmunoCAP Aspergillus IgG titer was also compared with the Aspergillus ICT test line intensity or rate of development, with weak to moderate correlations. The Aspergillus ICT lateral flow assay exhibits excellent sensitivity for serological diagnosis of CPA. Quantifying IgG from test line intensity measurements is not reliable. Given the short run time, simplicity, and limited resources needed, the LDBio Aspergillus ICT is a suitable diagnostic tool for CPA in resource-constrained settings.

scholarly journals Aspergillus fumigatus and Aspergillus flavus-Specific IgG Cut-Offs for the Diagnosis of Chronic Pulmonary Aspergillosis in Pakistan

2020 ◽  
Vol 6 (4) ◽  
pp. 249
Author(s):  
Kauser Jabeen ◽  
Joveria Farooqi ◽  
Nousheen Iqbal ◽  
Khalid Wahab ◽  
Muhammad Irfan
Keyword(s):  
Aspergillus Fumigatus ◽  
Sensitivity And Specificity ◽  
Aspergillus Flavus ◽  
Diagnostic Algorithm ◽  
Pulmonary Aspergillosis ◽  
Significant Difference ◽  
Ethical Approval ◽  
Chronic Pulmonary Aspergillosis ◽  
Specific Igg ◽  
First Time

Despite a high burden of chronic pulmonary aspergillosis (CPA) in Pakistan, Aspergillus-specific IgG testing is currently not available. Establishing cut-offs for Aspergillus-specific IgG for CPA diagnosis is crucial due to geographical variation. In settings such as Pakistan, where non-Aspergillus fumigatus (mainly A. flavus) Aspergillus species account for the majority of CPA cases, there is a need to explore additional benefit of Aspergillus flavus-specific IgG detection along with A. fumigatus-specific IgG detection. This study was conducted at the Aga Khan University, Karachi, Pakistan after ethical approval. Serum for IgG detection were collected after informed consent from healthy controls (n = 21), diseased controls (patients with lung diseases, n = 18), and CPA patients (n = 21). A. fumigatus and A. flavus IgG were detected using Siemens immulite assay. The sensitivity and specificity of A. fumigatus-specific IgG were 80.95% and 82.05%, respectively at a cut-off of 20 mg/L. The sensitivity and specificity of A. flavus-specific IgG were 80.95% and 79.49% at a cut-off of 30 mg/L. We report, for the first time, performance of A. flavus-specific IgG for CPA diagnosis. Although there was no statistically significant difference between the performance of both antigens, it seems contextually relevant to include A. flavus IgG in the CPA diagnostic algorithm in regions with higher non-A. fumigatus CPA infections.

Selection of Oral Antifungals for Initial Maintenance Therapy in Chronic Pulmonary Aspergillosis: A Longitudinal Analysis

2019 ◽  
Author(s):  
Masato Tashiro ◽  
Takahiro Takazono ◽  
Tomomi Saijo ◽  
Kazuko Yamamoto ◽  
Yoshifumi Imamura ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Cox Regression ◽  
Limited Data ◽  
Pulmonary Aspergillosis ◽  
Cox Regression Analysis ◽  
Crude Mortality ◽  
Oral Itraconazole ◽  
Chronic Pulmonary Aspergillosis ◽  
Observation Period

Abstract Background There are limited data for direct comparisons of the efficacy of oral itraconazole (ITCZ) and oral voriconazole (VRCZ) therapy in the treatment of chronic pulmonary aspergillosis (CPA). Methods We conducted a retrospective, follow-up, observational study of CPA patients enrolled in 2 previous multicenter trials. Results Of the 273 CPA patients, 59 and 101 patients started maintenance therapy with oral ITCZ and oral VRCZ, respectively, just after the end of acute intravenous therapy in each trial. At the end of the observation period in this follow-up study (median observation period, 731 days), the percentage of patients who showed improvement was lower in the ITCZ group than in the VRCZ group (18.2% vs 40.0%). However, after including stable patients, the percentages were 50.9% and 52.6%, respectively, in the ITCZ and VRCZ groups, which were not significantly different (P = .652). Multivariable Cox regression analysis showed no significant influence of the choice of initial maintenance treatment (ITCZ or VRCZ) on overall mortality as well as CPA-associated mortality. Multivariable logistic regression showed that oral ITCZ selection for initial maintenance therapy was an independent risk factor for hospital readmission and switching to other antifungal agents (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.3–7.5 and OR, 5.7; 95% CI, 2.0–15.7, respectively). Conclusions Oral VRCZ for initial maintenance therapy showed better effectiveness than oral ITCZ for clinical improvement in CPA patients. There was no difference in crude mortality between initial maintenance therapy with VRCZ and ITCZ, especially in elderly CPA patients.

Sign in / Sign up

Export Citation Format

Share Document