Allergic broncho-pulmonary aspergillosis among asthmatic patients in Zagazig area

ABSTRACT

Aspergilli, especially A. fumigatus could cause a variety of allergic reactions. Extrinsic asthma to Aspergilli is prevalent in Sharkia Governorate. Out of 200 asthmatic patients, 115 [57.5%] were sensitive to one or two of Apergillus antigens [Mycelial mat extract and acetone precipitated culture filtrate]. Not all these patients responded well to hyposensitisation performed. When investigated it was found that 35 of them [17.5%] had precipitins by ID method. This group of patients with precipitins had also higher total oesinophilic count [x=931] and higher total Ig[E] [x=2129] and most of them had bronchiectasis [80%], +ve sputum culture to one or both of A. fumigatus or A. niger [68.6%]. All these data suggest that ABPA is not uncommon in asthmatic patients reactive to aspergillus species. Patients fullfilling the criteria of ABPA should be diagnosed since hyposensitisation will not benefit them, on the contrary it may aggravate the presence of precipitins and censequently the reaction of the lung