Clinico-radiological and serological features in Allergic bronchopulmonary aspergillosis

<b>Aims and Objectives:</b> To describe Clinico-radiological and serological features in Allergic bronchopulmonary aspergillosis (ABPA). <b>Methods:</b> Asthmatics presenting to our hospital over a period of 2 years were screened with an Aspergillus skin test. Patients who were found to be positive were further investigated for ABPA. Patients were also arbitrarily classified as ABPA-seropositive (ABPA-S), ABPA with central bronchiectasis (ABPA-CB), and ABPA-CB with High-attenuation mucus (ABPA-CB-HAM) based on the high-resolution CT findings. <b>Results:</b> ABPA was diagnosed in 50 patients with a majority of patients are over 60years of age (28%) and with a male predominance of 56%. History of antituberculous therapy was present in 21(42%) and History of smoking was seen in 13(26%) of patients. The majority of patients (70%) had bronchiectasis in HRCT at presentation to our hospital. There were 15 patients (30%) with ABPA-S, 23 patients (46%) with ABPA-CB, and 12 patients (24%) with ABPA-CB-HAM. There was no significant difference between the stages of ABPA, and the serologic findings (absolute eosinophil count, IgE levels [total] and IgE levels [specific for Aspergillus fumigatus]). <b>Conclusions:</b> There is a high prevalence of ABPA in asthmatic patients presenting at our hospital. The disease entity is still underrecognized in India, the vast majority of patients have bronchiectasis at presentation, and almost half are initially misdiagnosed as having pulmonary tuberculosis. There is a need to redefine the diagnostic criteria of ABPA and to develop a gold standard diagnostic test. This study places emphasis on using IgE levels specific for Aspergillus fumigatus as a screening test for ABPA.