Allergic bronchopulmonary aspergillosis in Japan: A nationwide survey
Allergic bronchopulmonary aspergillosis in Japan: A nationwide survey
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DOI：
10.1016/j.alit.2017.04.011
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发表时间：
2018-01-01
影响因子：
6.8
通讯作者：
Asano, Koichiro
中科院分区：
文献类型：
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作者：
Oguma, Tsuyoshi;Taniguchi, Masami;Asano, Koichiro
背景：过敏性支气管肺曲霉病(ABPA)是一种过敏性肺部疾病，其特征是对定植于呼吸道的曲霉菌产生超敏反应。ABPA的临床特征可能因遗传和环境背景而异。我们在日本开展了一项全国性的调查，以确定ABPA的临床特征。方法：2013年，向903家呼吸系统或过敏性疾病医疗中心发出了一份关于医生诊断的ABPA/过敏性支气管肺真菌病的调查问卷。符合以下标准的病例被归类为可能的ABPA中枢性支扩(ABPA-CB)：1)血清特异性免疫球蛋白E(IgE)抗体或皮肤对曲霉菌呈阳性反应，2)中央支气管扩张或粘液嵌顿。结果：132个临床中心报告的499例经内科医生诊断的病例中，358例符合ABPA-CB的可能标准。ABPA-CB的发病年龄中位数为57岁(四分位数范围，44-68岁)，发病较晚，发病年龄<50岁，占66%，与女性、哮喘起病延迟和血清IgE水平降低有关。三分之一的患者(120例，34%)的血清总IgE水平较低(
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 (