Prevalence of allergic bronchopulmonary aspergillosis in cystic fibrosis patients using two different diagnostic criteria

Maleki, Mohammadreza; Mortezaee, Vida; Hassanzad, Maryam; Mahdaviani, Seyed Alireza; Poorabdollah, Mihan; Mehrian, Payam; Behnampour, Nasser; Mirenayat, Maryam Sadat; Abastabar, Mahdi; Tavakoli, Mahin; Hedayati, Mohammad Taghi

doi:10.23822/eurannaci.1764-1489.121

Cited by 15 publications

(14 citation statements)

References 14 publications

(16 reference statements)

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“…The latest globally implemented diagnostic criteria were proposed by the International Society for Human and Animal Mycology (ISHAM) Working Group in 2013. Their criteria include (1) history of asthma or CF; (2) positive Aspergillus skin testing with a wheal diameter greater than 3 mm or elevated IgE against A. fumigatus above 0.1 kUA/L, and elevated total serum IgE above 1000 IU/mL; (3) at least two of the following: (a) precipitating serum antibodies against A. fumigatus or elevated serum Aspergillus IgG, (b) mucous plugging or central bronchiectasis seen on chest imaging, or (c) total eosinophil count greater than 500 cells/mL in steroid-naïve patients [13].…”

Section: Discussionmentioning

confidence: 99%

“…There are multiple diagnostic criteria, which include a combination of radiological findings as well as serologic and immunologic studies, in order to establish the diagnosis of ABPA. The vast majority of them either include the presence of asthma or CF as an integral part of the diagnostic algorithm, or the criteria is specifically made for patients with CF [2,3]. However, an increasing number of reported ABPA cases do not strictly satisfy all diagnostic criteria or are presented atypically, which causes delays in diagnosis and subsequent initiation of appropriate medical treatment [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Allergic Bronchopulmonary Aspergillosis With or Without Asthmatic Symptoms?

Acosta-Rivera

Melendez-Montañez

Jesus-Rojas

2021

Cureus

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Allergic Bronchopulmonary Aspergillosis With or Without Asthmatic Symptoms?

Acosta-Rivera

Melendez-Montañez

Jesus-Rojas

2021

Cureus

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“…Although there are many diagnostic criteria for ABPA, Maleki et al showed that there was no significant differences on the reported rate of ABPA prevelance between the Cystic Fibrosis Foundation and International Society for Human and Animal Mycology (ISHAM) diagnostic criteria (32).…”

Section: Diagnosismentioning

confidence: 99%

Current Approach in the Diagnosis and Management of Allergic Bronchopulmonary Aspergillosis in Children With Cystic Fibrosis

et al. 2020

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Allergic bronchopulmonary aspergillosis (ABPA) is a complex pulmonary disorder characterized by a hypersensitivity reaction to Aspergillus fumigatus, and almost always seen in patients with cystic fibrosis (CF) and asthma. Fungal hyphae leads to an ongoing inflammation in the airways that may result in bronchiectasis, fibrosis, and eventually loss of lung function. Despite the fact that ABPA is thought to be more prevalent in CF than in asthma, the literature on ABPA in CF is more limited. The diagnosis is challenging and may be delayed because it is made based on a combination of clinical features, and radiologic and immunologic findings. With clinical deterioration of a patient with CF, ABPA is important to be kept in mind because clinical manifestations mimic pulmonary exacerbations of CF. Early diagnosis and appropriate treatment are important in preventing complications related to ABPA. Treatment modalities involve the use of anti-inflammatory agents to suppress the immune hyperreactivity and the use of antifungal agents to reduce fungal burden. Recently, in an effort to treat refractory patients or to reduce adverse effects of steroids, other treatment options such as monoclonal antibodies have started to be used. Intensive research of these new agents in the treatment of children is being conducted to address insufficient data.

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“…Maleki et al found no significant effect on the reported prevalence of ABPA in CF patients depending on the applied criteria [ 45 ].…”

Section: Diagnosis Of Abpa In Patients With Cfmentioning

confidence: 99%

Allergic Bronchopulmonary Aspergillosis in Children with Cystic Fibrosis: An Update on the Newest Diagnostic Tools and Therapeutic Approaches

et al. 2020

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Cystic fibrosis (CF), the most common autosomal-recessive genetic disease in the Caucasian population, is characterized by frequent respiratory infections and progressive lung disease. Fungal species are commonly found in patients with CF, and among them, Aspergillus fumigatus is the most frequently isolated. While bacteria, particularly Pseudomonas aeruginosa, have a well-established negative effect on CF lung disease, the impact of fungal infections remains unclear. In patients with CF, inhalation of Aspergillus conidia can cause allergic bronchopulmonary aspergillosis (ABPA), a Th2-mediated lung disease that can contribute to disease progression. Clinical features, diagnostic criteria and treatment of ABPA are still a matter of debate. Given the consequences of a late ABPA diagnosis or the risk of ABPA overdiagnosis, it is imperative that the diagnostic criteria guidelines are reviewed and standardized. Along with traditional criteria, radiological features are emerging as tools for further classification as well as novel immunological tests. Corticosteroids, itraconazole and voriconazole continue to be the bedrock of ABPA therapy, but other molecules, such as posaconazole, vitamin D, recombinant INF-γ and Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) modulators, have been showing positive results. However, few studies have been conducted recruiting CF patients, and more research is needed to improve the prevention and the classification of clinical manifestations as well as to personalize treatment. Early recognition and early treatment of fungal infections may be fundamental to prevent progression of CF disease. The aim of this narrative review is to give an update on ABPA in children with CF.

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Prevalence of allergic bronchopulmonary aspergillosis in cystic fibrosis patients using two different diagnostic criteria

Cited by 15 publications

References 14 publications

Allergic Bronchopulmonary Aspergillosis With or Without Asthmatic Symptoms?

Allergic Bronchopulmonary Aspergillosis With or Without Asthmatic Symptoms?

Current Approach in the Diagnosis and Management of Allergic Bronchopulmonary Aspergillosis in Children With Cystic Fibrosis

Allergic Bronchopulmonary Aspergillosis in Children with Cystic Fibrosis: An Update on the Newest Diagnostic Tools and Therapeutic Approaches

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