Chest radiographic staging in allergic bronchopulmonary aspergillosis: relationship with immunological findings.

Hdl Handle:
http://hdl.handle.net/10147/209177
Title:
Chest radiographic staging in allergic bronchopulmonary aspergillosis: relationship with immunological findings.
Authors:
Kiely, J L; Spense, L; Henry, M; Hurley, M F; Kelleher, N; Bredin, C P
Affiliation:
Dept of Respiratory Medicine, Cork University Hospital, Wilton, Ireland.
Citation:
Eur Respir J. 1998 Aug;12(2):453-6.
Journal:
The European respiratory journal : official journal of the European Society for, Clinical Respiratory Physiology
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209177
PubMed ID:
9727800
Abstract:
The question of whether a chest radiographic severity staging system could be correlated with standard blood/serum diagnostic indices in allergic bronchopulmonary aspergillosis (ABPA) was addressed in 41 patients. Asthma and positive Aspergillus fumigatus (AF) serology were considered essential diagnostic inclusion criteria. Eosinophil count, serum immunoglobulin (Ig)E and immediate skin hypersensitivity were also tested to grade patients as "definite" or "likely" ABPA. Definite cases had all five of these factors present, whereas likely cases had three or more. Chest radiographs were examined by experienced radiologists blinded to the clinical data. The six-stage radiographic score (0-5) was based on the severity and duration of changes seen: stage 0: normal; stage 1: transient hyperinflation; stage 2: transient minor changes; stage 3: transient major changes; stage 4: permanent minor changes; and stage 5: permanent major changes. Significant positive correlations (p<0.05) were observed between peak AF titres (expressed as an index), peak eosinophil count and radiographic severity stage. When considered as subgroups, these correlations approached, but did not reach, significance for the group with "likely" ABPA (n=28), but in the group with definite ABPA (n=13), there was a high correlation between radiographic score and peak AF index (r=0.59), as well as peak eosinophil count (r=0.62). This study suggests that the peak Aspergillus fumigatus index and eosinophil counts correlate best with the severity of radiographic stages in allergic bronchopulmonary aspergillosis. This chest radiographic staging system may be useful in the clinical assessment and management of patients with allergic bronchopulmonary aspergillosis, particularly in those patients with more severe radiographic stages.
Language:
eng
MeSH:
Antibodies, Fungal/blood; Aspergillosis, Allergic Bronchopulmonary/*immunology/*radiography; Aspergillus fumigatus/immunology/isolation & purification; Eosinophils; Humans; Immunoglobulin E/blood; Leukocyte Count; Lung/*radiography; Middle Aged; Skin Tests
ISSN:
0903-1936 (Print); 0903-1936 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorKiely, J Len_GB
dc.contributor.authorSpense, Len_GB
dc.contributor.authorHenry, Men_GB
dc.contributor.authorHurley, M Fen_GB
dc.contributor.authorKelleher, Nen_GB
dc.contributor.authorBredin, C Pen_GB
dc.date.accessioned2012-02-03T15:14:18Z-
dc.date.available2012-02-03T15:14:18Z-
dc.date.issued2012-02-03T15:14:18Z-
dc.identifier.citationEur Respir J. 1998 Aug;12(2):453-6.en_GB
dc.identifier.issn0903-1936 (Print)en_GB
dc.identifier.issn0903-1936 (Linking)en_GB
dc.identifier.pmid9727800en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209177-
dc.description.abstractThe question of whether a chest radiographic severity staging system could be correlated with standard blood/serum diagnostic indices in allergic bronchopulmonary aspergillosis (ABPA) was addressed in 41 patients. Asthma and positive Aspergillus fumigatus (AF) serology were considered essential diagnostic inclusion criteria. Eosinophil count, serum immunoglobulin (Ig)E and immediate skin hypersensitivity were also tested to grade patients as "definite" or "likely" ABPA. Definite cases had all five of these factors present, whereas likely cases had three or more. Chest radiographs were examined by experienced radiologists blinded to the clinical data. The six-stage radiographic score (0-5) was based on the severity and duration of changes seen: stage 0: normal; stage 1: transient hyperinflation; stage 2: transient minor changes; stage 3: transient major changes; stage 4: permanent minor changes; and stage 5: permanent major changes. Significant positive correlations (p<0.05) were observed between peak AF titres (expressed as an index), peak eosinophil count and radiographic severity stage. When considered as subgroups, these correlations approached, but did not reach, significance for the group with "likely" ABPA (n=28), but in the group with definite ABPA (n=13), there was a high correlation between radiographic score and peak AF index (r=0.59), as well as peak eosinophil count (r=0.62). This study suggests that the peak Aspergillus fumigatus index and eosinophil counts correlate best with the severity of radiographic stages in allergic bronchopulmonary aspergillosis. This chest radiographic staging system may be useful in the clinical assessment and management of patients with allergic bronchopulmonary aspergillosis, particularly in those patients with more severe radiographic stages.en_GB
dc.language.isoengen_GB
dc.subject.meshAntibodies, Fungal/blooden_GB
dc.subject.meshAspergillosis, Allergic Bronchopulmonary/*immunology/*radiographyen_GB
dc.subject.meshAspergillus fumigatus/immunology/isolation & purificationen_GB
dc.subject.meshEosinophilsen_GB
dc.subject.meshHumansen_GB
dc.subject.meshImmunoglobulin E/blooden_GB
dc.subject.meshLeukocyte Counten_GB
dc.subject.meshLung/*radiographyen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshSkin Testsen_GB
dc.titleChest radiographic staging in allergic bronchopulmonary aspergillosis: relationship with immunological findings.en_GB
dc.contributor.departmentDept of Respiratory Medicine, Cork University Hospital, Wilton, Ireland.en_GB
dc.identifier.journalThe European respiratory journal : official journal of the European Society for, Clinical Respiratory Physiologyen_GB
dc.description.provinceMunster-
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