Prevalence of Allergic Bronchopulmonary Aspergillosis in Asthmatic and Allergic Rhinitis Patients at a Tertiary Care Centre

Authors

  • Mehvish Eram Chishty
  • Areena Hoda Sidiqqui
  • Vishal Parmar
  • Snehil Singh
  • Neha Tiwari

Keywords:

Allergic bronchopulmonary aspergillosis, asthma, allergic rhinitis, skin prick test, Aspergillus fumigatus, IgE, IgG, CECT, eosinophilia

Abstract

Background: Allergic bronchopulmonary aspergillosis (ABPA) is a Th2-mediated pulmonary disorder triggered by Aspergillus fumigatus, primarily affecting individuals with bronchial asthma and allergic rhinitis. Characterized by eosinophilia, elevated IgE levels, and structural lung abnormalities, ABPA remains underdiagnosed, especially in resource-constrained settings, resulting in progressive airway damage and long-term morbidity.

Aim and Objectives: This study aimed to evaluate the prevalence of ABPA among patients with asthma and allergic rhinitis at a tertiary care centre. Specific objectives included assessment of hypersensitivity using skin prick testing (SPT), evaluation of immunological markers through ELISA, and correlation of seropositivity with radiological findings.

Materials and Methods: An observational study was conducted from May 2023 to November 2024 at the Integral Institute of Medical Sciences and Research, enrolling 160 patients with clinically diagnosed asthma and/or allergic rhinitis. All participants underwent SPT using Aspergillus fumigatus antigens. Peripheral eosinophilia was assessed via differential leukocyte count and absolute eosinophil count (AEC). Serum total IgE, and A. fumigatus-specific IgE and IgG levels were determined using ELISA. Chest radiographic evaluation and contrast-enhanced computed tomography (CECT) were performed in selected cases.

Results: Of the 160 patients, bronchial asthma was diagnosed in 47.05%, allergic rhinitis in 28.75%, and both conditions in 23.75%. SPT positivity was observed in 58.1% of cases, with a higher rate among females (67.69%). Elevated AEC was noted in 73% of patients. Among 77 SPT-positive individuals undergoing CECT, 90.9% showed abnormal findings—predominantly bronchiectasis (26%) and pulmonary opacity (23.4%). ELISA revealed A. fumigatus-specific IgE in 15.05% and specific IgG in 13.98% of SPT-positive patients. Elevated total IgE was observed in 19.35%, predominantly in asthma cases. These findings indicate a significant burden of ABPA-related immunological and radiological markers in patients with allergic airway diseases.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Agarwal, R., et al. (2020). Allergic bronchopulmonary aspergillosis: Review of literature. Journal of Fungi, 6(2), 75. https://doi.org/10.3390/jof6020075

Agarwal, R., et al. (2017). Diagnostic criteria for allergic bronchopulmonary aspergillosis: A systematic review and meta-analysis. Journal of Allergy and Clinical Immunology: In Practice, 5(3), 812–819. https://doi.org/10.1016/j.jaip.2016.09.007

Agarwal, R., et al. (2018). Risk factors for ABPA in patients with asthma. Journal of Asthma and Allergy, 11, 207–216. https://doi.org/10.2147/JAA.S165789

Ahmad, A. (Year). Dermatophytosis and its mycological correlation in patients attending a tertiary care hospital. [Journal Name], [Volume(Issue)], pp.-pp. ← Add missing journal info

Baxter, C. G., et al. (2013). Serologic tests in the diagnosis of ABPA. Clinical and Vaccine Immunology, 20(5), 663–670. https://doi.org/10.1128/CVI.00010-13

Denning, D. W., et al. (2016). Chronic pulmonary aspergillosis: Rationale and clinical guidelines for diagnosis and management. European Respiratory Journal, 47(1), 45–68. https://doi.org/10.1183/13993003.00583-2015

Ghosh, S., et al. (2018). Correlation of culture and serological markers in ABPA patients. Mycoses, 61(6), 409–417. https://doi.org/10.1111/myc.12763

Greenberger, P. A. (2002). Allergic bronchopulmonary aspergillosis. Journal of Allergy and Clinical Immunology, 110(5), 685–692. https://doi.org/10.1067/mai.2002.128834

Hedayati, M. T., et al. (2007). Aspergillus flavus: Human pathogen, allergen, and mycotoxin producer. Microbiology, 153(6), 1677–1692. https://doi.org/10.1099/mic.0.2007/006676-0

Kosmidis, C., et al. (2015). The clinical spectrum of pulmonary aspergillosis. Thorax, 70(3), 270–277. https://doi.org/10.1136/thoraxjnl-2014-206291

Kumari, M., Siddiqui, M. A., & Gupta, A. (2023). Recent advancement and novel application of natural polyphenols for the treatment of allergy asthma: From phytochemistry to biological implications. Critical Reviews™ in Immunology, 43(4), pp.-pp. ← Add missing page range

Li, X., et al. (2019). Molecular diagnostic advances for Aspergillus infections. Frontiers in Microbiology, 10, 2839. https://doi.org/10.3389/fmicb.2019.02839

Masaki, Y., et al. (2018). Diagnostic strategies for allergic bronchopulmonary aspergillosis. Allergy and Asthma Proceedings, 39(3), 180–188. https://doi.org/10.2500/aap.2018.39.4122

Maurya, V., et al. (2011). Skin test reactivity to fungal allergens in patients with respiratory allergy. Indian Journal of Allergy, Asthma and Immunology, 25(2), 97–102.

Patterson, K., et al. (2021). Allergic bronchopulmonary aspergillosis: Current diagnostic and treatment strategies. Annals of Allergy, Asthma & Immunology, 126(1), 26–32. https://doi.org/10.1016/j.anai.2020.10.007

Rick, E. M., et al. (2020). Diagnostic challenges in Aspergillus-related lung diseases. European Journal of Clinical Microbiology & Infectious Diseases, 39(3), 511–525. https://doi.org/10.1007/s10096-019-03769-w

Shah, A., et al. (2009). Allergic bronchopulmonary aspergillosis: The Indian perspective. Current Opinion in Pulmonary Medicine, 15(1), 72–80. https://doi.org/10.1097/MCP.0b013e32831da8fa

Slavin, R. G., et al. (2018). Allergic fungal sinusitis and ABPA: Overview and treatment. Journal of Allergy and Clinical Immunology: In Practice, 6(5), 1420–1432. https://doi.org/10.1016/j.jaip.2018.02.009

Stevens, D. A., et al. (2016). Aspergillosis: Disease spectrum, diagnosis, and treatment. Infectious Disease Clinics of North America, 30(1), 123–151. https://doi.org/10.1016/j.idc.2015.10.012

Takazono, T., et al. (2021). Serum biomarkers in ABPA diagnosis. Journal of Infection and Chemotherapy, 27(2), 304–312. https://doi.org/10.1016/j.jiac.2020.08.017

Vyas, A., et al. (2019). Role of skin prick test in diagnosing fungal allergies. Indian Journal of Chest Diseases and Allied Sciences, 61(1), 15–20.

Wang, J. L., et al. (2020). Identification of Aspergillus fumigatus in respiratory samples by culture and PCR. Journal of Medical Microbiology, 69(2), 223–230. https://doi.org/10.1099/jmm.0.001155

..

Downloads

Published

2025-04-29

How to Cite

1.
Chishty ME, Sidiqqui AH, Parmar V, Singh S, Tiwari N. Prevalence of Allergic Bronchopulmonary Aspergillosis in Asthmatic and Allergic Rhinitis Patients at a Tertiary Care Centre. J Neonatal Surg [Internet]. 2025Apr.29 [cited 2025Oct.7];14(19S):683-9. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/4851

Issue

Vol. 14 No. 19S (2025): Journal of Neonatal Surgery

Section

Original Article

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

You are free to:

  • Adapt — remix, transform, and build upon the material for any purpose, even commercially.

Terms:

  • Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
  • No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.