Allergic bronchopulmonary mycosis in patients with asthma: period prevalence at a university hospital in Saudi Arabia

Abstract

Allergic bronchopulmonary mycosis (ABPM) is a known complication of asthma and can result in progressive lung damage, respiratory failure and death. Asthma is a common disease in Saudi Arabia and until now the prevalence of ABPM has not been investigated. The aim of this study was to estimate the period prevalence of ABPM due to Aspergillus and Candida in patients with asthma. The setting was an outpatient pulmonary clinic at a university hospital in the central region of Saudi Arabia. Two hundred and sixty-four consecutive patients with asthma (150 or 57% females) were evaluated. All patients were screened for ABPM with skin prick test (SPT) using a panel of fungal antigens. Those with positive skin reactions had further clinical, immunological, respiratory and radiological assessment. ABPM was diagnosed by the presence of a minimum of five of the major criteria suggested by Rosenberg in 1977. Of the 264 patients, 62 (23%) had a positive SPT for at least one fungal allergen, of whom 44 (71%) were females (P=0.01). Seven patients (six females) were diagnosed with ABPM due to Aspergillus and (or) Candida species. Therefore, we estimate the period prevalence of ABPM to be 2.7% (95% confidence interval 1.3-5.4%). A. niger was the commonest fungal species isolated in our group. In conclusion, ABPM is not uncommon in Saudi Arabia and females seem to be more at risk. Because asthma is common, physicians need to have high index of suspicion for this disease and pursue the diagnosis with the appropriate tests.

Identifying rare diseases using electronic medical records: the example of allergic bronchopulmonary aspergillosis

“…This proportion is much lower than the prevalence of ABPA observed in a series of case studies (range: 0.72–4.10%) 7, 8, 9, 10, 11, 12. However, when mentioned, the term ‘ABPA’ coincided with other terms also indicative of ABPA, which is suggestive that the mention of ABPA may have represented a true diagnosis.…”

“…However, in a previous study using data from five referral cohort studies (China, Ireland, New Zealand, Saudi Arabia and South Africa), the prevalence of ABPA in adults with asthma was estimated at 2.5% (range: 0.72–3.50%) 7, 8, 9, 10, 11, 12. In another case series study in Iran, the prevalence of ABPA among asthmatic patients was estimated at 4.1% 13.…”

Prevalence of Allergic Broncho Pulmonary Aspergillosis in patients with Asthma attending allergy clinic in a North West Indian Tertiary Care Institute

“…Some of the studies took only A. fumigatus antigen for skin testing, while others included other fungal allergens too. [4,5,7,[13][14][15][16][17][18] Similarly, type I, type III and type IV skin test reactivity was considered in some studies and only type I in others. [3,4,7,13,17] There was also a difference in the type of skin test used in various studies like some studies used prick test while others used intradermal test.…”

“…[3,4,7,13,17] There was also a difference in the type of skin test used in various studies like some studies used prick test while others used intradermal test. [4][5][6][7][13][14][15] All these factors may contribute to diversity of the results.…”

Microbial Allergy with Special Focus on Saudi Arabia

“…This generally develops in atopic subjects and is sustained by the continuous in halation of Aspergillus antigens, resulting in acute asthma (Sugar and Olek, 1998). The prevalence of ABPA also varies from 1 to 11% in patients with asthma (Eaton et al, 2000;Al-Mobeireek et al, 2001) and from 25-28% in Aspergillus skin test-positive asthmatic subjects (Eaton et al, 2000). These variable prevalence rates probably reflect the lack of a single diagnostic criterion with a standardized test (Shah, 1994).…”