DOI: 10.36347/sjams.2018.v06i04.005

Pages: 1401-1404

True prevalence of ABPA among asthmatics is not known, may be attributed to the lack of a uniform diagnostic criterion and standard tests. To determine the prevalence of ABPA in bronchial asthma. All patients of bronchial asthma from January 2012 to September 2015 were evaluated and diagnosis of ABPA was made according to criteria laid down by Rosenberg et al. 479 patients completed the study. 40.9% patients of bronchial asthma who had AEC of > 1000 along with radiological abnormalities were further investigated for ABPA with non specific IgE levels >1000ng/ml, elevated levels of IgG and IgE specific for Aspergillosis and HRCT chest. IgE levels of > 1000ng/ml was detected in 38.7%, IgG-Af was positive in 30.6%, IgE-Af was positive in 31.6% of patients and both IgE-Af and IgG-Af were positive in 28.6% patients. HRCT chest was done only in 36.2% patients due to economic constrains. Central bronchiectasis was detected in 73.2%, homogeneous shadows (fleeting infiltrates) in 91.5%, parallel line shadows in 54.9% ring shadows in 32.4%, honey comb shadows in 22.5%, tramline Shadows in 19.7%, atelectasis in 26.8% and cavitation was seen in 15.5% of patients. 14.2 % patients of bronchial asthma had ABPA diagnosed on basis of presence of at least five of the eight major criteria described above. Interestingly 67.6% of these patients diagnosed as ABPA were misdiagnosed as pulmonary tuberculosis, and were on anti tuberculosis treatment. Results of our study conclude that ABPA is under diagnosed inspite of its relatively high prevalence.