PT  - JOURNAL ARTICLE
AU  - Chotirmall, Sanjay Haresh
AU  - Branagan, Peter
AU  - Gunaratnam, Cedric
AU  - McElvaney, Noel Gerard
TI  - Aspergillus/Allergic Bronchopulmonary Aspergillosis in an Irish Cystic Fibrosis Population: A Diagnostically Challenging Entity
DP  - 2008 Aug 01
TA  - Respiratory Care
PG  - 1035--1041
VI  - 53
IP  - 8
4099  - http://rc.rcjournal.com/content/53/8/1035.short
4100  - http://rc.rcjournal.com/content/53/8/1035.full
AB  - BACKGROUND: Patients with cystic fibrosis (CF) can become colonized by aspergillus, which can act as an allergen and cause allergic bronchopulmonary aspergillosis (ABPA). OBJECTIVE: To determine the rate of aspergillus colonization and ABPA in a population of Irish patients with CF. METHODS: In 50 consecutive patients with CF who presented with exacerbations, we looked for the presence of aspergillus in their sputum and signs and symptoms of ABPA. RESULTS: Fifteen patients (30%) grew aspergillus species in their sputum cultures. Six patients (12%) had ABPA. Matched for age, sex, genotype, and microbiology, there was no significant difference in forced expiratory volume in the first second (percent predicted, FEV1%) in subjects with aspergillus-positive sputum compared to those not colonized with aspergillus. Subjects with ABPA experienced sharp short-term deterioration in lung function (mean 6.7% predicted FEV1), which returned to baseline following at least 4 weeks of treatment. CONCLUSIONS: The prevalence of ABPA was 12%. Aspergillus-positive sputum of itself was not a poor prognostic sign in terms of lung function over the 5-year study course. ABPA produces short-term reversible declines in lung function and responds to treatment. The frequency of aspergillus isolates did not correlate with the occurrence of ABPA. A low threshold for the diagnosis of ABPA should be maintained in any patient with CF who does not improve with antibiotics.