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. 2020 Feb;14(2):140-147.
doi: 10.1111/crj.13111. Epub 2019 Dec 5.

The clinical characteristics and prognosis of ABPA are closely related to the mucus plugs in central bronchiectasis

Hai-Wen Lu  1 , Bei Mao  1 , Ping Wei  1 , Sen Jiang  2 , Hong Wang  1 , Cheng-Wei Li  1 , Xiao-Bing Ji  1 , Shu-Yi Gu  1 , Jia-Wei Yang  1 , Shuo Liang  1 , Ke-Bin Cheng  1 , Jiu-Wu Bai  1 , Wei-Jun Cao  1 , Xin-Ming Jia  1 , Jin-Fu Xu  1
Affiliations

The clinical characteristics and prognosis of ABPA are closely related to the mucus plugs in central bronchiectasis

Hai-Wen Lu et al. Clin Respir J. 2020 Feb.

Abstract

Introduction: The characteristics of Allergic Bronchopulmonary Aspergillosis (ABPA) based on its radiological classification is still unclear.

Objectives: To investigate the clinical significances of ABPA patients with central bronchiectasis (ABPA-CB) by different radiological classifications of mucus plugs.

Methods: ABPA-CB patients from a pulmonary hospital between 2008 and 2015 were retrospectively included and analysed. According to the chest imaging in their first visit to physician, the ABPA-CB patients were divided into two groups based on the presence of high-attenuation mucus (HAM) or low-attenuation mucus (LAM). The primary endpoint was ABPA relapse within 1 year since the glucocorticoid withdrawal. The relationship between the imaging findings and the clinical prognosis was illuminated.

Results: A total of 125 ABPA patients were analysed in this study. Compared to the LAM group, the HAM group presented higher blood eosinophil cells counts, higher rates of Aspergillus detection isolated in sputum and expectoration of brownish-black mucus plugs, more affected lobes and segments, poorer pulmonary function and higher rate of relapse.

Conclusions: The clinical characteristics and prognosis of ABPA-CB patients are closely related to its radiological phenotype of mucus plugs in the central bronchiectasis. Clinicians should promote a diversity of personalized treatments for different patients with different radiological characteristics.

Keywords: allergic bronchopulmonary; aspergillosis; prognosis; radiology.

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Conflict of interest statement

All the authors do not have any possible conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart. Study design and subject disposition
Figure 2
Figure 2
CT scans and bronchoscopy images of HAM before and after the comprehensive treatment. (A,B,C): before the treatment. (D,E,F): after the treatment
Figure 3
Figure 3
CT scans and bronchoscopy images of LAM before and after the comprehensive treatment. (A,B,C): before the treatment. (D,E,F): after the treatment
Figure 4
Figure 4
The scatter diagrams associated with the CT value of mucus in ABPA‐CB patients. The value of r represents the correlation coefficients between the CT value of mucus and age (A), eosinophil count on blood (B), FEV1% (C) and PEF% (D). The lines represents the relation trend of these indicators
See this image and copyright information in PMC

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