2172 Allergic bronchopulmonary aspergillosis in asthma and lung tuberculosis

Thursday, 15 October 2015
Hall D1 Foyer (Floor 3) (Coex Convention Center)

Juwita Soekarno, Physician , Internal Medicine, Medical Faculty of Univesity of Sam Ratulangi, Manado, Indonesia

Sarie Ratnasari, MD , Internal Medicine Department, Samratulangi Unversity Manado, Manado, Indonesia

E. Alwi Datau , Allergy&immunology Division, Samratulangi University Manado, Manado, Indonesia

Eko Surachmanto, MD , Internal Medicine Department, Samratulangi University Manado, Manado, Indonesia

JC Matheos, MD , Internal Medicine Department, Samratulangi University Manado, Manado, Indonesia


Background:Allergic bronchopulmonary aspergillosis (ABPA) is a lung disease that is caused by hypersensitivity reaction to the fungus Aspergillus fumigatus, where its colonization often found in chronic respiratory disease, either in bronchial asthma and lung tuberculosis. History of asthma in ABPA is often obtained from 5-10 years earlier. Lung tuberculosis is often difficult to distinguish with ABPA due to similar radiological features, often found as misdiagnosis in a previous study

Methods:Observational descriptive analytic with cross sectional approach, conducted in Prof. Dr.R.D. Kandou Hospital in Manado, from July-December 2013.  Total 75 samples from 3 groups, each 25 samples: moderate-severe persistent asthma, Acid-Fast Bacilli (AFB) positive lung TB and AFB negative lung TB. Chest x-ray examination, skin prick test (SPT) using A. fumigatus antigen (rapid reaction/type I early and late/8 hours type III), total IgE, and IgG anti A. fumigatus are obtained. Greenberger assessment criterias are used for ABPA

Results: ABPA was found 1.55% (4/258) in moderate-persistent asthma, 0.64% (3/469) in FAB positive lung TB and 0.57% (6/1054) in AFB negative lung TB. Correlation between type I SPT and total IgE showed significant results (p<0.05) in moderate-severe persistent asthma and AFB negative lung TB, but is not significant in AFB positive lung TB, while the correlation between IgG A. fumigatus and type III SPT has very significant (p <0.001) results in all groups; Conclusion:ABPA is found either in asthma or lung tuberculosis patients. Significant correlation between IgG A.fumigatus and type III SPT may indicate SPT to replace IgG A. fumigatus examination which is currently a research kit. SPT examination may be considered as screening of suspected ABPA.

Keywords: Allergic bronchopulmonary aspergillosis, lung tuberculosis, moderate-severe persistent asthma, skin prick test, total IgE, IgG A. fumigatus