Attapattu M C
Department of Medical Mycology, Medical Research Institute, Colombo.
Ceylon Med J. 1991 Jun;36(2):45-51.
Allergic bronchopulmonary aspergillosis (ABPA), an immunologically mediated lung disease is now well recognised as a significant cause of chronic lung disease in the West. This study aimed at determining the extent of this entity in 540 patients with severe bronchial asthma and 96 patients with mild or moderate asthma. Of these 134 were subjected to detailed examinations in the form of a skin test, serological test, sputum examination and peripheral blood eosinophil count. Eight patients (1.2% of the total and 6% of selected patients) had evidence of ABPA. A further 50 patients (8% of total and 37% of selected patients) had evidence of allergy to the fungus as depicted by positive skin test reactivity. The latter patients could be either early ABPA or potential candidates for the development of ABPA later. Skin test sensitivity to both Aspergillus fumigatus and A niger were demonstrated in Sri-Lankan asthmatics. Skin test sensitivity could be considered a screening test for the diagnosis of ABPA. A scheme for the diagnosis of ABPA using simple criteria could be devised keeping in mind the cost and availability of tests.
变应性支气管肺曲霉病（ABPA）是一种免疫介导的肺部疾病，目前在西方已被公认为慢性肺部疾病的重要病因。本研究旨在确定540例重度支气管哮喘患者和96例轻度或中度哮喘患者中该疾病的患病程度。其中134例患者接受了皮肤试验、血清学检测、痰液检查和外周血嗜酸性粒细胞计数等详细检查。8例患者（占总患者数的1.2%，占所选患者的6%）有ABPA的证据。另有50例患者（占总患者数的8%，占所选患者的37%）皮肤试验反应阳性，表明对该真菌过敏。后一组患者可能处于ABPA早期，或以后有发展为ABPA的潜在可能。在斯里兰卡哮喘患者中证实了对烟曲霉和黑曲霉的皮肤试验敏感性。皮肤试验敏感性可被视为ABPA诊断的筛查试验。考虑到检测的成本和可及性，可以设计一种使用简单标准诊断ABPA的方案。
