Case analysis based on 2017 version of Expert Consensus on the Diagnosis and Treatment of Allergic Bronchopulmonary Aspergillosis / 上海交通大学学报（医学版）

ABSTRACT

Objective: To analyze the cases of ABPA based on 2017 version of Expert Consensus on the Diagnosis and Treatment of Allergic Bronchopulmonary Aspergillosis (ABPA) (Expert Consensus in short) developed by Asthma Group of Chinese Medical Association Respiratory Diseases Society. Methods: According to the Expert Consensus, the clinical data of 12 patients with ABPA admitted to Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2013 to December 2017 were retrospectively analyzed. Results: Among the 12 patients with ABPA, 6 were males and 6 were females. The clinical manifestations were cough, having phlegm, short of breath, etc. The total immunoglobulin E (tIgE) in sera of 10 cases increased, and the peripheral blood eosinophils of 9 cases increased. Seven cases underwent the skin test, 3 of whom were positive in aspergillus. Serum aspergillus-specific IgE (sIgE) of all the 5 cases tested was elevated. The most patients showed bronchiectasis in chest CT, and some also with mucus plug. Fifty percent of the cases fully met the diagnostic criteria of Expert Consensus. All the patients were treated with corticosteroid, and 9 of them were also treated with antifungal drugs. Conclusion: The clinical manifestations of ABPA are atypical. For the patients with lung diseases such as asthma and bronchiectasis, serum tIgE, aspergillus sIgE and eosinophil levels need to be monitored. Aspergillus skin test and imaging examination are helpful to the diagnosis of ABPA. The main treatment is the combination of corticosteroid and antifungal drugs.