Sensitization to Aspergillus and Allergic Bronchopulmonary Aspergillosis in a Cystic Fibrosis Population

Abstract

ABSTRACT

The prevalence of sensitization to Aspergillus and of allergic bronchopulmonary aspergillosis (ABPA) was studied in 222 patients with cystic fibrosis (CF) older than 6 years of age. Sensitization to Aspergillus was evaluated by both skin prick and intradermal testing. Signs of ABPA were considered: positive prick or intradermal test or both, total serum IgE (PRIST) levels above 2 SD of the mean for age, specific IgE (RAST) ≥ 0.7 PRU/ml, serum precipitating antibodies, peripheral eosinophilia (>0.35 × 10⁹ cells/L), and asthma. ABPA was considered probable if five criteria were achieved and possible if only four were present (always including a positive Aspergillus skin test). Of 222 patients, 124 (56%) were sensitized to Aspergillus, and they showed a worse clinical score and pulmonary function than did nonsensitized subjects. Fifty-two (23%) had ABPA without any substantial clinical difference (age, Chrispin-Norman chest x-ray score, clinical score, pulmonary function) between those with probable (n = 27) and those with possible (n = 25) ABPA. Subjects with ABPA had worse clinical score, radiologic score, and pulmonary function than those who were not sensitized to Aspergillus. These data point out the high prevalence of sensitization to Aspergillus and of ABPA in CF and their relationship with a worse clinical condition.