TY - JOUR
T1 - Allergic bronchopulmonary aspergillosis in Japan
T2 - A nationwide survey
AU - Oguma, Tsuyoshi
AU - Taniguchi, Masami
AU - Shimoda, Terufumi
AU - Kamei, Katsuhiko
AU - Matsuse, Hiroto
AU - Hebisawa, Akira
AU - Takayanagi, Noboru
AU - Konno, Satoshi
AU - Fukunaga, Koichi
AU - Harada, Kazuki
AU - Tanaka, Jun
AU - Tomomatsu, Katsuyoshi
AU - Asano, Koichiro
N1 - Funding Information:
We thank Ms. Naoko Yatabe and Mafumi Kawarabata for their excellent technical contributions to this study. We also thank all the physicians who cooperated in our nationwide survey of ABPA (See Supplementary file: List of Collaborators). This work was supported by Research Grant on Allergic Disease and Immunology from the Japan Agency for Medical Research and Development.
Funding Information:
We thank Ms. Naoko Yatabe and Mafumi Kawarabata for their excellent technical contributions to this study. We also thank all the physicians who cooperated in our nationwide survey of ABPA ( See Supplementary file: List of Collaborators ). This work was supported by Research Grant on Allergic Disease and Immunology from the Japan Agency for Medical Research and Development .
Publisher Copyright:
© 2017 Japanese Society of Allergology
PY - 2018/1
Y1 - 2018/1
N2 - Background Allergic bronchopulmonary aspergillosis (ABPA) is an allergic pulmonary disease characterized by a hypersensitivity reaction to Aspergillus species colonizing the airways. The clinical characteristics of ABPA may differ depending on genetic and environmental background. We performed a nationwide survey to determine the clinical characteristics of ABPA in Japan. Methods In 2013, a questionnaire on physician-diagnosed ABPA/allergic bronchopulmonary mycosis was sent to 903 medical centers specializing in respiratory or allergic diseases. Cases fulfilling the following criteria were categorized as possible ABPA-central bronchiectasis (ABPA-CB): 1) presence of specific serum immunoglobulin E (IgE) antibodies or a positive skin reaction to Aspergillus, and 2) bronchiectasis or mucoid impaction in the central bronchi. Results Of 499 physician-diagnosed cases reported by 132 clinical centers, 358 cases met the criteria for possible ABPA-CB. Median age of ABPA-CB onset was 57 (interquartile range, 44–68) years; later-onset disease, developing ≥50 years of age, accounted for 66% of the cases and was associated with female sex, delayed onset of asthma, and lower levels of serum IgE. A third of the patients (120 patients, 34%) exhibited low levels of serum total IgE (<1000 IU/mL). Aspergillus species were isolated from sputum in 126/213 cases (59%), and Schizophyllum commune was identified in 12 (6%) patients. During the course of the treatment, ABPA recurred in 169 (48%) cases. Conclusions This nationwide survey identified several unique clinical characteristics of ABPA in Japan, such as late-onset, relatively lower serum IgE levels, and frequent recurrences/flares.
AB - Background Allergic bronchopulmonary aspergillosis (ABPA) is an allergic pulmonary disease characterized by a hypersensitivity reaction to Aspergillus species colonizing the airways. The clinical characteristics of ABPA may differ depending on genetic and environmental background. We performed a nationwide survey to determine the clinical characteristics of ABPA in Japan. Methods In 2013, a questionnaire on physician-diagnosed ABPA/allergic bronchopulmonary mycosis was sent to 903 medical centers specializing in respiratory or allergic diseases. Cases fulfilling the following criteria were categorized as possible ABPA-central bronchiectasis (ABPA-CB): 1) presence of specific serum immunoglobulin E (IgE) antibodies or a positive skin reaction to Aspergillus, and 2) bronchiectasis or mucoid impaction in the central bronchi. Results Of 499 physician-diagnosed cases reported by 132 clinical centers, 358 cases met the criteria for possible ABPA-CB. Median age of ABPA-CB onset was 57 (interquartile range, 44–68) years; later-onset disease, developing ≥50 years of age, accounted for 66% of the cases and was associated with female sex, delayed onset of asthma, and lower levels of serum IgE. A third of the patients (120 patients, 34%) exhibited low levels of serum total IgE (<1000 IU/mL). Aspergillus species were isolated from sputum in 126/213 cases (59%), and Schizophyllum commune was identified in 12 (6%) patients. During the course of the treatment, ABPA recurred in 169 (48%) cases. Conclusions This nationwide survey identified several unique clinical characteristics of ABPA in Japan, such as late-onset, relatively lower serum IgE levels, and frequent recurrences/flares.
KW - Allergic bronchopulmonary aspergillosis
KW - Aspergillus
KW - Bronchiectasis
KW - Immunoglobulin E
KW - Schizophyllum commune
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U2 - 10.1016/j.alit.2017.04.011
DO - 10.1016/j.alit.2017.04.011
M3 - Article
C2 - 28546015
AN - SCOPUS:85019547990
SN - 1323-8930
VL - 67
SP - 79
EP - 84
JO - Allergology International
JF - Allergology International
IS - 1
ER -