Allergy and Airway: Asthma and Allergy |

Retrospretrospective Analysis and Follow-Up Study on the Clinical and Prognostic Factors of Allergic Bronchopulmonary Aspergillosis Abstract FREE TO VIEW

Haiwen Lu, MD; Jinfu Xu, PhD
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Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A2. doi:10.1016/j.chest.2016.02.004
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SESSION TITLE: Asthma and Allergy

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, April 17, 2016 at 02:15 PM - 03:45 PM

PURPOSE: Allergic bronchopulmonary aspergillosis (ABPA) is a type of non-infectious inflammatory bronchopulmonary disease whose morbidity has long been underestimated. The relationships between clinical manifestation, disease severity and the new ABPA radiologic classifications are still not clear.

METHODS: We recorded the age, sex, disease course, clinical manifestation, blood routine, pulmonary function test, bronchoscopy, chest images, treatment, and prognosis of ABPA patients clinically diagnosed during the period from January 2002 to December 2013 by the method of retrospective analysis and prospective follow-up. ABPA patients were divided into seropositive-ABPA (ABPA-S) and central bronchiectasis ABPA (ABPA-CB) groups according the chest HRCT results based on the presence or absence of CB. Then, based on the presence or absence of high attenuation mucus (HAM) and other radiologic findings (ORF), the ABPA-CB group was divided into three sub-groups; i.e., ABPA-CB (non-HAM and non-ORF), ABPA-CB-HAM, and ABPA-CB-ORF. The relationship between the pulmonary function indexes, the immune index, the prognosis and radiologic findings in each group with the above classifications were analyzed.

RESULTS: A total of 139 patients were included in the study. The small airway obstruction in the ABPA-CB group was more serious mainly in FEV1 (%) and PEF (%) in the predicted values, and in the ercentage of FEV1/FVC (%) (both p < 0.05). The median EOS in the ABPA-CB-ORF group was 547.00 cells/ml. In this group, pulmonary function was impaired more obviously compared with the ABPA-CB (non-HAM and non-ORF) group, not only in small airway ventilatory function [FEV1 (%), PEF (%): p < 0.05], but also in FVC (%). However, the Eos in the ABPA-CB-HAM group were significantly higher than in the ABPA-CB group. Also, small airway ventilatory dysfunction in the APBA-CB-HAM group was more serious. The relapse rates of ABPA-CB and ABPA-CB-HAM groups were as high as 39.43% and 65.00%, respectively; both of whose recurrences were higher than the ABPA-S group. (both p < 0.05)

CONCLUSIONS: It is more conducive for clinicians to accurately evaluate the severity and prognosis of patients with ABPA to divide them into ABPA-S and ABPA-CB groups on the basis of chest HRCT manifestations, and then to divide the ABPA-CB group into three sub-groups of ABPA-CB (non-HAM and non-ORF), ABPA-CB-HAM and ABPA-CB-ORF.

CLINICAL IMPLICATIONS: The chest imaging can help us to estimate the prognosis and formulate the treatment options

DISCLOSURE: The following authors have nothing to disclose: Haiwen Lu, Jinfu Xu

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