title: Serologic allergic bronchopulmonary aspergillosis (ABPA-S): long-term outcomes.
abstract: OBJECTIVE
  ABPA is radiologically classified on the presence or absence of central bronchiectasis (CB) as ABPA-CB and serologic ABPA (ABPA-S) respectively. Few studies have described the follow-up of patients with ABPA-S. The aim of this retrospective study was to describe the outcomes of ABPA-S.
  
  
  METHODS
  Patients were diagnosed as ABPA-S if they met all the following criteria: asthma, immediate cutaneous hyperreactivity to Aspergillus fumigatus antigen, total IgE levels >1000 IU/mL, A. fumigatus specific IgE levels >0.35 kUA/L and normal HRCT of the chest. They were treated with glucocorticoids and followed up with history, physical examination, chest radiograph and total IgE levels every 6 weeks to 3 months. In addition, an annual spirometry and a biennial HRCT chest were performed in all patients.
  
  
  RESULTS
  Of the 55 patients with ABPA-S, 41 (17 men, 24 women; mean age, 38.3 years) consented for performance of repeat HRCT scans. The median duration of asthma prior to diagnosis of ABPA was six years. The duration of follow-up ranged from 24 to 77 months with the mean (SD) follow-up duration being 43.7 (10.1) months. There was improvement in FEV(1) but not the FVC values during the follow-up period (p values = 0.001 and 0.5 for FEV(1) and FVC respectively). There was no development of CB in any patient. Sixteen patients had a relapse during the follow-up period, and six patients were classified as glucocorticoid-dependent ABPA.
  
  
  CONCLUSIONS
  Although relapses are frequently seen, the long-term outcome of ABPA-S is good with no patient developing CB.
authors.affiliation: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh-160012, India. riteshpgi@gmail.com
authors.forename: Ritesh
authors.initials: R
authors.lastname: Agarwal
authors.forename: Mandeep
authors.initials: M
authors.lastname: Garg
authors.forename: Ashutosh N
authors.initials: AN
authors.lastname: Aggarwal
authors.forename: Biman
authors.initials: B
authors.lastname: Saikia
authors.forename: Dheeraj
authors.initials: D
authors.lastname: Gupta
authors.forename: Arunaloke
authors.initials: A
authors.lastname: Chakrabarti
mesh_terms: D000328:Adult; D000946:Antigens, Fungal / Q000097:blood; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D001232:Aspergillus fumigatus / Q000276:immunology; D001249:Asthma / Q000150:complications / Q000503:physiopathology; D001987:Bronchiectasis / Q000517:prevention & control; D004359:Drug Therapy, Combination; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D010808:Physical Examination; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014797:Vital Capacity / Q000502:physiology
chemical_list: D000946:Antigens, Fungal; D005938:Glucocorticoids; D007073:Immunoglobulin E