Clinical Analysis of 77 Patients with Allergic Bronchopulmonary Aspergillosis in Peking Union Medical College Hospital.

Objective To summarize the clinical features of allergic bronchopulmonary aspergillosis(ABPA)to facilitate its early diagnosis and treatment. Methods We retrospectively analyzed the clinical data of 77 patients who had been admitted to Peking Union Medical College Hospital from January 1996 to July 2015 with ABPA. Results The average age of these 77 patients(38 men and 39 women)was(41.8±18.3)years. The co-morbidities included bronchial asthma(n=74,96%)and pulmonary cystic fibrosis(n=3,4%). The main symptoms and signs of ABPA were chronic cough(100%),sputum production(97%),wheeze(86%),sputum plugs(25%),blood-stained sputum(18%),hemoptysis(9%),chest pain(9%),fever(47%),weight loss(30%),and night sweat(12%). Laboratory tests revealed elevated levels of blood eosinophils absolute count(87%),anti-aspergillus antigen-specific IgE(89%)and specific IgG(57%)as well as a positive result of Aspergillus antigen skin test(88%). Pulmonary function testing showed that the incidences of obstructive ventilation and diffusion dysfunction were 66% and 65%,respectively;in addition,bronchodilatation test showed positive result in 60% of the patients. The most common CT findings were central bronchiectasis(81%),patchy infiltrations(79%),pleural thickening(49%),mediastinal adenopathy(35%),nodular opacities(25%),mucoid impaction(21%),and fleeting infiltrations(35%). In addition,44 cases(58%)were misdiagnosed as tuberculosis,pneumonia,lung abscess,and/or lung cancer autoimmune diseases. Conclusions ABPA can be easily misdiagnosed. ABPA should be carefully considered in patients with asthma or pulmonary cystic fibrosis who also suffer from wheeze,sputum plugs,elevated eosinophils central bronchiectasis,and fleeting infiltrations.