title: Therapeutic bronchoalveolar lavage with conventional treatment in allergic bronchopulmonary aspergillosis.
abstract: OBJECTIVE
  To establish the role of therapeutic bronchoalveolar lavage in addition to conventional treatment among two groups, with allergic bronchopulmonary aspergillosis, in terms of regression in serum IgE levels and clinical recurrence at 3 and 6 months of follow-up.
  
  
  METHODS
  Aquasi-experimental study.
  
  
  METHODS
  Department of Pulmonology, Fauji Foundation Hospital, Rawalpindi, from July 2010 to December 2013.
  
  
  METHODS
  The study was carried out on 132 patients who fulfilled the Greenberger and Patterson criteria and underwent a chest X-ray, an HRCT chest and classified radiologically as with Central Bronchiectasis (CB), High Attenuation Mucus (HAM) or Other Radiological Features (ORF). Baseline serum IgE levels were noted. All patients were given treatment including prednisolone and antifungal agent itraconazole for 4 months. Patients with ORF on HRCTchest and just received the medical treatment were labeled as conventional group. Those patients who had CB or HAM radiological features also underwent bronchoscopy with therapeutic Bronchoalveolar Lavage (BAL), labeled as BALgroup. Clinical recurrence and serum IgE levels were noted at 3 and 6 months. Values were compared using chi-square and Mann-Whitney tests respectively.
  
  
  RESULTS
  Around 78 (59.1%) of patients underwent bronchoscopy with therapeutic bronchoalveolar lavage to remove the mucus plugs. The mean serum IgE levels at baseline were 3312.04 ± 2526.217 and 3486.15 ± 2528.324 IU/ml in the BAL and conventional groups respectively. There was a statistically significant reduction in the mean serum IgE levels at 3 (p < 0.00) and 6 months (p < 0.001) of follow-up in BALas compared to conventional group. There was no significant difference in the clinical recurrence rate in both the groups (p=0.078 at 3 and 0.343 at 6 months respectively).
  
  
  CONCLUSIONS
  Therapeutic bronchoalveolar lavage may be a useful adjunct to treatment in patients with allergic bronchopulmonary aspergillosis, serum in terms of IgE level reduction.
authors.affiliation: Department of Pulmonology, Fauji Foundation Hospital, Rawalpindi.
authors.forename: Kanwal Fatima
authors.initials: KF
authors.lastname: Khalil
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000382:microbiology / Q000628:therapy*; D018893:Bronchoalveolar Lavage; D001999:Bronchoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D017964:Itraconazole / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D011239:Prednisolone / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D000935:Antifungal Agents; D017964:Itraconazole; D007073:Immunoglobulin E; D011239:Prednisolone