Original Research Article
Year: 2020 | Month: April | Volume: 7 | Issue: 4 | Pages: 1-8
Aspergillus Antigen Hypersensitivity – A Severity Marker of Bronchial Asthma? – A Hospital Based Comparative Study
Dhwani Gopinath1, DK Manoj2
1Assistant Professor, Department of Pulmonary Medicine, MES Medical College, Perinthalmanna, Malappuram, Kerala, India.
2Professor, Department of Pulmonary Medicine, Government Medical College, Pariyaram, Kannur, Kerala, India
Corresponding Author: Dhwani Gopinath
ABSTRACT
Background: Asthma is an inflammatory disease characterized by airway hyper-responsiveness which is a significant public health problem with more than 300 million affected individuals. About two third of asthmatic patients are atopic to common allergens. Only a few studies specifically evaluated the relation between Aspergillus sensitization and severity of bronchial asthma and none from this part of the country.
Methods: This was a hospital based non-interventional observational study of 100 asthmatic patients. After obtaining informed consent and applying necessary inclusion and exclusion criteria, the study population was assessed in detail with set proforma and spirometry before and after bronchodilation. The clinical profile of bronchial asthma and pattern of Aspergillus sensitivity in this part of the country was assessed. The association of Aspergillus antigen hypersensitivity with severity of bronchial asthma was an integral part of this study.
Results: The mean age of study group was 41.7 years with majority being house wives. Allergy for dust and mites were present in 97%. Cough breathlessness and rhinitis were the major symptoms and polyphonic wheeze the major sign. Prevalence of Aspergillus hypersensitivity was 34% and Aspergillus fumigates was the most common strain responsible for the same. Spirometry revealed increased severity of bronchial asthma among the sensitive group.
Conclusions: Patients with Aspergillus hypersensitivity had significantly worse clinical course, more hospitalizations, more clinical signs and a much worse pulmonary function test. So any patient with bronchial asthma it would be advisable to do an intradermal Aspergillus testing to predict the clinical course.
Keywords: Aspergillus fumigates, bronchial asthma, hypersensitivity, pulmonary function test, allergy, intradermal antigen testing
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