Exploring the Epidemiology and Clinico-Demographic Characteristics of Allergic Bronchopulmonary Aspergillosis in Children with Cystic Fibrosis

Abstract

Objective This study aimed to find the prevalence and clinico-demographic profile of cystic fibrosis (CF) children with allergic bronchopulmonary aspergillosis (ABPA).

Methods A cross-sectional study was conducted at a CF clinic of a tertiary care hospital. Participants included the diagnosed cases of children with CF, of both genders, from 4 to 18 years of age.

Results A total of 61 patients were enrolled. Sixteen patients (26.2%) had Aspergillus fumigatus sensitization—among these, 10 (16.4%) patients fulfilled the minimum diagnostic criteria for ABPA and 6 (9.8%) had A. fumigatus sensitization only. Two patients were below the age of 5 years, while eight patients were more than 6 years old. The female-to-male ratio was 6:4. High attenuated mucus was the specific finding in our study cohort on computed tomography (CT) chest. All patients with ABPA had significantly higher median (interquartile range [IQR]) levels of total IgE, specific IgE, and IgG for A. fumigatus, and total eosinophil count compared to patients without ABPA. There was also a significant decrease in forced exhalation volume in first second (FEV1) values (6 months apart) in ABPA patients.

Conclusion Our study found that ABPA affects 16.4% of our CF population, with 20% of cases occurring in children aged 4 to 5 years. We observed a higher prevalence of ABPA in patients from rural areas. Eosinophilia and serial decline in FEV1 values were observed as potential early markers for ABPA.