Clinico- Radiological Correlation in Allergic Bronchopulmonary Aspergillosis (ABPA) Detected in Children with Poorly Controlled Asthma

M. Singh1, A. Chakrabarti2, M. Verma1, A. Chauhan1;

Author address: 

1Pediatrics, Postgrraduate Institue of Medical Education and Research, Chandigarh, India, 2Microbiology, Postgrraduate Institue of Medical Education and Research, Chandigarh, India.

Abstract: 

Introduction: Allergic bronchopulmonary aspergillosis is a pulmonary disorder which is associated with poorly controlled asthma. Diagnosis of ABPA is based upon the set of a combination of clinical history of asthma, immunological and radiological parameters. The aim of this study was to correlate the clinical and radiological parameters in children with ABPA detected in poorly controlled asthma. Methodology: Children with poorly controlled asthma who attended Advanced Pediatric Centre in Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, were enrolled in the study after taking informed consent of their parents/guardians. The Diagnosis of ABPA was done on the basis of Rosenberg-Patterson criteria. Ethical approval No. PGI/IEC/2011/727-728. Total Serum IgE & Specific IgE Levels were assayed with commercially available kits using the quantitative enzyme linked immunosorbent assay (ELISA) Aspergillus Skin test (AST): The procedure consisted of an intradermal injection of 0.2ml of 1:1000 Aspergillus fumigatus antigen in the forearm. Radiological investigations: All children had chest radiographs and high resolution chest Computed Tomography. The findings on radiological investigation were analysed and correlated with clinical findings. It was done with the help of chest X-ray and high resolution computed tomography (HRCT). Results: Out of the 150 enrolled children with asthma, 87 were poorly controlled and 63 were well controlled asthma. Out of 87 poorly controlled children with asthma, there were 28 (32%) children with ABPA. The radiological finding of ABPA includes fleeting shadows, opacities, infilterates, bronchoectasis, lymphadenopathy, perihilar regions, Atelectasis, centrilobular nodules and mucus plugging as compared to poorly controlled asthma were having hyperinflation and normal HRCT. Out of 28 ABPA patients, 4(14.2%) were having bronchietasis and categorized as ABPA-CB, 2(7.1%) were having mosaic attenuation as ABPA-HAM, 8(28.5%) were serological positive as ABPA-S and 14(50.0%) as ABPA-ORF with hyperinflated lungs, lymphadenopathy, patchy consolidation, fibrocavitory changes, centrilobular nodules, and mucus plugging seen. Conclusion: Other radiological findings(ABPA -ORF) had a higher prevalence than serological ABPA(ABPA-S), central-bronchietasis (ABPA-CB) and high attenuation mucus (ABPA-HAM). About one fourth of patients had no radiological findings hence they were serologically positive. Acknowledgement: Indian Council of Medical Research -DHR, for providing funds for research work of project no GIA/58/2014-DHR, Delhi .

2018

abstract No: 

A1432 / P962

Full conference title: 

The American Thoracic Society Conference 2018
    • ATS 2018