Allergic bronchopulmonary aspergillosis (ABPA) patients with a history of asthma and/or central bronchiectasis are prone to frequent acute exacerbations, and longer durations of asthma history and misdiagnosis, mucus plugs, and poor pulmonary function are risk factors for these acute exacerbation of ABPA, reveals a new study.  

This retrospective cohort study, which was the largest sample size study of ABPA in China, and was conducted by a group of researchers from Zhongshan Hospital, Fudan University, China, investigated the clinical characteristics of ABPA for the first time in such detail. The researchers found that out of the 232 ABPA patients, 132 had a history of misdiagnosis, though patients with central bronchiectasis, a high total eosinophil count, and mucus plugs were less likely to be misdiagnosed. It also found that ABPA with central bronchiectasis was more likely to occur in older people and in patients with mucus plugs, and decreased forced vital capacity and diffusing capacity for carbon monoxide. ABPA patients with asthma were more likely to have bronchiectasis, decreased lung function (found in 1 s FEV1 and FEV1/FVC), and shorter time to first acute exacerbation compared with ABPA patients without asthma. 

The study also concluded that use of glucocorticoids combined with antifungal drugs can prolong the time to the first acute exacerbation.