The Clinical Characteristics and Prognosis of ABPA Are Closely Related to the Mucus Plugs in Central Bronchiectasis

Author: 

Hai-Wen Lu, Bei Mao, Ping Wei, Sen Jiang, Hong Wang, Cheng-Wei Li, Xiao-Bing Ji, Shu-Yi Gu, Jia-Wei Yang, Shuo Liang, Ke-Bin Cheng, Jiu-Wu Bai, Wei-Jun Cao, Xin-Ming Jia, Jin-Fu Xu
Clin Respir J 2019 Nov 23

Abstract: 

Introduction: The characteristics of Allergic Bronchopulmonary Aspergillosis (ABPA) based on its radiological classification is still unclear.

Objectives: To investigate the clinical significances of ABPA patients with central bronchiectasis (ABPA-CB) by different radiological classifications of mucus plugs.

Methods: ABPA-CB patients from a pulmonary hospital between 2008 to 2015 were retrospectively included and analyzed. According to the chest imaging in their first visit to physician, the ABPA-CB patients were divided into two groups based on the presence of high-attenuation mucus (HAM) or low-attenuation mucus (LAM). The primary endpoint was ABPA relapse within 1 year since the glucocorticoid withdrawal. The relationship between the imaging findings and clinical prognosis was illuminated.

Results: A total of 125 ABPA patients were analyzed in this study. Compared to the LAM group, the HAM group presented higher blood eosinophil cells counts, higer rates of Aspergillus detection isolated in sputum and expectoration of brownish-black mucus plugs, more affected lobes and segments, poorer pulmonary function and higher rate of relapse.

Conclusions: The clinical characteristics and prognosis of ABPA-CB patients are closely related to its radiological phenotype of mucus plugs in the central bronchiectasis. Clinicians should promote a diversity of personalized treatments for different patients with different radiological characteristics.

Keywords: Allergic Bronchopulmonary; Aspergillosis; Prognosis; Radiology.