title: Prevalence of Aspergillus sensitisation in pulmonary tuberculosis-related fibrocavitary disease.
abstract: METHODS
  Aspergillus complicates the course of healed pulmonary tuberculosis (PTB), causing aspergilloma and chronic pulmonary aspergillosis. Whether Aspergillus also causes allergic sensitisation in PTB-related fibrocavitary disease and bronchiectasis remains unknown.
  
  
  OBJECTIVE
  To investigate the prevalence of Aspergillus sensitisation in healed fibrocavitary PTB.
  
  
  METHODS
  In a case-control design, consecutive symptomatic new referrals with PTB-related fibrocavitary disease underwent spirometry, Aspergillus skin test and computed tomography of the chest, determination of serum IgE levels (total and Aspergillus fumigatus-specific), serum precipitins against A. fumigatus and eosinophil count. Aspergillus sensitisation was defined as either a positive Aspergillus skin test or A. fumigatus IgE >0.35 kUA/l.
  
  
  RESULTS
  A total of 100 subjects (50 PTB-related fibrocavitary disease, 50 controls) with a mean age of 40.8 years (standard deviation [SD] 12.2) were enrolled. Aspergillus sensitisation was present in 16 (32%) cases and two (4%) controls. Fourteen cases (one control) had IgE values >1000 IU/ml, while two cases manifested eosinophilia. Aspergillus precipitins were positive in 13 cases (two controls); of these, 8 did not have Aspergillus sensitisation. The presence of airflow obstruction on spirometry was significantly associated with Aspergillus sensitisation on univariate analysis (OR 4.96, 95%CI 1.36-18.03).
  
  
  CONCLUSIONS
  There is a high prevalence of Aspergillus sensitisation in PTB-related fibrocavitary disease. The clinical relevance and therapeutic implications of this finding require further investigation.
authors.affiliation: <label>*</label>Department of Pulmonary Medicine, Chandigarh, India.
authors.forename: S
authors.initials: S
authors.lastname: Dhooria
authors.affiliation: <label>*</label>Department of Pulmonary Medicine, Chandigarh, India.
authors.forename: P
authors.initials: P
authors.lastname: Kumar
authors.affiliation: <label><sup>†</sup></label>Department of Immunopathology, Chandigarh, India.
authors.forename: B
authors.initials: B
authors.lastname: Saikia
authors.affiliation: <label>*</label>Department of Pulmonary Medicine, Chandigarh, India.
authors.forename: A N
authors.initials: AN
authors.lastname: Aggarwal
authors.affiliation: <label>*</label>Department of Pulmonary Medicine, Chandigarh, India.
authors.forename: D
authors.initials: D
authors.lastname: Gupta
authors.affiliation: <label>*</label>Department of Pulmonary Medicine, Chandigarh, India.
authors.forename: D
authors.initials: D
authors.lastname: Behera
authors.affiliation: <label><sup>‡</sup></label>Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: A
authors.initials: A
authors.lastname: Chakrabarti
authors.affiliation: <label>*</label>Department of Pulmonary Medicine, Chandigarh, India.
authors.forename: R
authors.initials: R
authors.lastname: Agarwal
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000382:microbiology; D001228:Aspergillosis / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012882:Skin Tests; D013147:Spirometry; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000382:microbiology* / Q000473:pathology
chemical_list: D007073:Immunoglobulin E