Misinterpretation of allergic bronchopulmonary aspergillosis/allergic bronchopulmonary mycosis due to diverse characteristics in different clinical stages
单位:[1]Department of Respiratory Medicine, Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing 100026, China[2]Department of Internal Medicine, Beijing Chaoyang District Health Service Center, Beijing 100013, China[3]Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Disease, Beijing 100029, China
Background: Allergic bronchopulmonary mycosis (ABPM) is a complex pulmonary disorder caused by a hyperimmune response to the endobronchial growth of certain fungi. This study aims to aid physicians in better understanding the need for earlier recognition of ABPM. Methods: Patients with a confirmed diagnosis of ABPM after evaluation were analyzed retrospectively. Clinical features, previous diagnoses and potential diagnostic errors, laboratory findings were reviewed and compiled. Results: Fifty-seven patients were diagnosed with ABPM in which 22 were misdiagnosed. Eosinophilia was observed in 11 patients and an elevated total serum Ig E level greater than 1,000 kU/L was detected in 25 of the 57 patients. All of the patients were tested for specific Ig E in which positive to different fungi. The two most common abnormalities found on chest high-resolution computed tomography (HRCT) exams were central bronchiectasis and mucus plugs. A mild to moderate obstructive pattern of lung function was observed in 32 cases. By bronchofiberscopic observation, bronchial lumen was seen to have significant inflammation in 12 patients. After 3 weeks of treatment, a decreased serum total Ig E value was observed. Conclusions: This study highlights the importance of increasing awareness and understanding of non-Aspergillus-ABPM among physicians and draws attention to the need for establishing more elaborate diagnostic criteria for non-Aspergillus-ABPM, which is a rare kind of disease.
基金:
Beijing Science and Technology Committee Project, Capital Public Health Incubation Program [Z141100002114006]; Capital Health Development Research Project, Independent Innovation Program [CD2014-2-1062]; National Nature Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [L1422025]; National Key R&D Program of China [2016YFC0206502]
第一作者单位:[1]Department of Respiratory Medicine, Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing 100026, China
共同第一作者:
通讯作者:
通讯机构:[3]Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Disease, Beijing 100029, China[*1]Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Disease, No. 2, Yinghuayuan East Street, Chaoyang District, Beijing 100029, China
推荐引用方式(GB/T 7714):
Feng Haijun,Lv Ping,Ren Xiaoxia,et al.Misinterpretation of allergic bronchopulmonary aspergillosis/allergic bronchopulmonary mycosis due to diverse characteristics in different clinical stages[J].JOURNAL of THORACIC DISEASE.2019,11(11):4484-4491.doi:10.21037/jtd.2019.10.78.
APA:
Feng, Haijun,Lv, Ping,Ren, Xiaoxia,Dai, Huaping&Yang, Ting.(2019).Misinterpretation of allergic bronchopulmonary aspergillosis/allergic bronchopulmonary mycosis due to diverse characteristics in different clinical stages.JOURNAL of THORACIC DISEASE,11,(11)
MLA:
Feng, Haijun,et al."Misinterpretation of allergic bronchopulmonary aspergillosis/allergic bronchopulmonary mycosis due to diverse characteristics in different clinical stages".JOURNAL of THORACIC DISEASE 11..11(2019):4484-4491