Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus species (generally Aspergillus fumigatus) that occurs almost exclusively in patients with asthma or, less commonly, cystic fibrosis. Immune responses to Aspergillus antigens cause airway obstruction and, if untreated, bronchiectasis and pulmonary fibrosis. Our objective was to define the clinical characteristics, laboratory and radiological findings of suspected ABPA cases among a cohort of Egyptian patients with bronchial asthma. 52 moderate and severe asthma patients were recruited from the Allergy and Immunology clinic at Ain Shams University hospitals. Patients were subjected to history taking for asthma symptoms, skin test with Aspergillus fumigatus antigen, total IgE level, peripheral blood eosinophilia, chest x-ray and high resolution CT chest. 27 patients had positive skin prick and /or intradermal test to Aspergillus fumigatus antigen, and 11 (21.2%) of them fulfilled 4 of the criteria for ABPA diagnosis. Patients with suspected ABPA had significantly higher serum total IgE levels (median (IQR) = 625 IU/ml (514.9-762) with P-value <0.0001). Our study suggests a high frequency of suspected ABPA cases for further confirmation by appropriate diagnostic tests; there is a need for better recognition of ABPA as it is yet under recognized in Egypt Clinicians ought to have a high index of suspicion for ABPA while managing any patient with bronchial asthma to detect ABPA prior to development of irreversible complications.
Copyright© by the Egyptian Association of Immunologists.