الفهرس 
PathogenesisOnly 14 pages are availabe for public view
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Abstract
Aim of work: The aim of the work is to assess Prevalence of ABPA in bronchial asthma and The efficacy of HRCT in diagnosis of ABPA. Patients and methods: This case control study was carried out in Thoracic Medicine Department in Collaboration with Clinical Pathology and Radiology Departments, Mansoura University Hospital during the period from January 2004 to August 2006. This study comprised 210 patients with bronchial asthma including 83 males and 127 females with age raging from 21 to 66 years with mean 43 5.0 years. Results: Aspergillin skin test positivity was found in 22.86% (48 out of 210) of cases of bronchial asthma (BA). The grades of severity of BA in Aspergillin skin test +ve cases were higher than Aspergillin –ve cases (31.25% vs 16.6% for severe persistent BA, 41.66% vs 40.12% for moderate persistent BA and 27.08% vs 24.69% for mild persistent BA). ABPA was diagnosed in 3.81% of cases of BA (8 out of 210) with 2.86% of the BA cases diagnosed as ABPA-CB (6 out of 210) and 0.96% of the BA cases were diagnosed as ABPA-S (2 out of 210). While among Aspergillin skin test +ve cases, the prevalence of ABPA was 16.6% (8 out of 48) with 12.5% of the cases as ABPA-CB (6 out of 48) and 4.2% as ABPA-S (2 out of 48). The degree of severity of BA with ABPA was higher than in BA without ABPA (87.5% vs 17.33% for severe persistent BA). Also, all cases of ABPA-CB were severe persistent BA compared to 50% of cases of ABPA-S. The degree of severity of BA (severe persistent BA) were significantly higher than non severe persistent BA (mild and moderate) regarding total IgE, eosinophils, systemic steroids and ABPA (431.1 303.1 vs 124 108.1, 6.0 2.4 vs 4.6 1.7, 14 (100%) vs 17 (51.5%) 7 (46.7%) vs 1 (3%) respectively) (P = 0.002, 0.023, 0.001, 0.000 respectively). There were higher degree of positivity of Aspergillin skin test +ve with ABPA vs Aspergillin skin test +ve without ABPA (50% vs 0% for +3 degree and 50% vs 30% for +2 degree). Conclusions: Aspergillin skin test positivity is high in patients with BA (22.86%) and is associated with a higher prevalence of ABPA (16.6%). ABPA is not a rare disease in BA, as it occurs in 3.8% of cases of BA (8 out of 210). ABPA can be predicted in patients with BA especially if they have higher degree of Aspergillin skin test positivity (+3 and +2).