Clinical Spectrum of Aspergillosis in Children with Severe Asthma: A Retrospective Observational Study
Correspondence Address :
Dr. Payal Agrawal,
Assistant Professor, Department of Paediatrics, SGT Medical College, Gurugram-122505, Haryana, India.
E-mail: p.agrawal7610@gmail.com
Introduction: Aspergillus species can affect the respiratory system of genetically predisposed asthma patients. Allergic Broncho-Pulmonary Aspergillosis (ABPA) is one of the manifestations of aspergillosis. Most research on ABPA has been conducted in the adult population, with very few studies including paediatric patients.
Aim: To examine the clinical spectrum of aspergillosis in severely asthmatic children aged between 2 and 18 years admitted to the Paediatric Intensive Care Unit (PICU).
Materials and Methods: This retrospective observational study was conducted from September 2021 to August 2022. Out of 76 children aged between 2 and 18 years who presented with asthma over one year, 24 children fulfilling the inclusion criteria (severe asthma requiring PICU admission) were included in the study by convenient sampling. Children were diagnosed with ABPA and Severe Asthma with Fungal Sensitisation (SAFS) based on the ISHAM (International Society for Human and Animal Mycology) work group criteria (history of asthma, raised Aspergillus-specific and total Immunoglobulin E (IgE), presence of Aspergillus-specific IgG, eosinophilia, and positive radiological findings). Descriptive statistics elaborated in the form of mean and standard deviation.
Results: A total of 24 patients with acute severe asthma were admitted to the PICU over one year. Nearly 60% (15/24) of the patients fulfilled the criteria for subgroup A (comprising poorly controlled asthma, eosinophilia, or positive radiological findings). Among them, six (25%) patients had total serum IgE levels > 1000 IU/mL, three (12.5%) had levels between 500-1000 IU/mL, and six (25%) had levels <500 IU/mL. Among these patients, 60% (9/15) had elevated Aspergillus-specific IgE and IgG levels. As per the ISHAM work group criteria, 6/24 (25%) patients were diagnosed with S-ABPA (Serological ABPA) and 3/24 (12.5%) patients were diagnosed with SAFS.
Conclusion: Aspergillus sensitivity is increasingly being detected in asthmatic children, requiring further work-up, especially in patients with poorly controlled asthma.
Aspergillus sensitivity, Bronchopulmonary disease, Respiratory infection
DOI: 10.7860/JCDR/2024/67492.19285
Date of Submission: Sep 12, 2023
Date of Peer Review: Dec 01, 2023
Date of Acceptance: Jan 22, 2024
Date of Publishing: Apr 01, 2024
Author declaration:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Sep 12, 2023
• Manual Googling: Dec 13, 2023
• iThenticate Software: Jan 20, 2024 (8%)
Etymology: Author Origin
Emendations: 7
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