Nonimmunocompromised patients with allergic bronchopulmonary aspergillosis: clinical analysis of 11 cases / 中华临床感染病杂志

ABSTRACT

Objective To analyze the clinical features of nonimmunocompromised patients with allergic bronchopulmonary aspergillosis (ABPA).Methods The clinical data of 11 nonimmunocompromised patients diagnosed as ABPA from June 2010 to December 2015 in Zhejiang Jinhua People's Hospital were retrospectively analyzed.SPSS 18.0 was used for analysis.Results Among 11 patients with ABPA, Five were males and 6 were females, with an average age of (49.3 ±11.0) years.All patients had cough, expectoration and wheezing;cough and tan sputum in 4 cases, bloody sputum in 3 cases, fever in 2 cases and chest pain in 2 cases.In auscultation dry rales were heard in all patients , and limited wet rales were heard in 3 cases.The peripheral blood leukocyte counts were elevated in 5 patients [11.7(10.3-13.5) × 109/L)] and the eosinophils counts were increased in 9 patients [1.79(0.09-7.63) ×109/L].The total IgE was elevated to 3640(1329-9430) IU/mL.Skin prick test was positive ( grade 3 to 5) in 10 cases, Aspergillus fumigatus specific IgE increased to 23.6(1.75-67.30) kU/L in 6 cases, Aspergillus fumigatus specific IgG raised to 83.3(51-126) mg/L in 5 cases.Chest CT showed patchy, punctate exudation in 8 cases, central bronchiectasis in 9 cases, bronchial mucosal plug formation in 4 cases, and atelectasis in 1 case.Mediastinal lymph nodes were found in 2 cases.All 11 patients were treated with glucocorticoid hormone, and 8 patients were also received itraconazole oral solution for treatment.After treatment, the clinical symptoms were improved rapidly.Conclusion Nonimmunocompromised patients with ABPA have no specific clinical manifestations , and often are misdiagnosed as asthma , which is worth the attention of clinicians.