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- Title
Epidemiology and outcomes of allergic bronchopulmonary aspergillosis in the elderly.
- Authors
Muthu, Valliappan; Sehgal, Inderpaul Singh; Prasad, Kuruswamy Thurai; Dhooria, Sahajal; Garg, Mandeep; Aggarwal, Ashutosh N.; Chakrabarti, Arunaloke; Agarwal, Ritesh
- Abstract
Background: The prevalence and outcomes of allergic bronchopulmonary aspergillosis (ABPA) in the elderly remain unknown. Methods: We reviewed our database to identify the proportion of subjects diagnosed with ABPA at ≥60 years of age (ABPA‐elderly). We compared the clinical features, treatment and outcomes of ABPA‐elderly versus the non‐elderly (ABPA diagnosed at <60 years of age). Results: Between 2007 and 2019, we encountered 810 ABPA subjects with a mean age of 34.9 years (49.4% women). Of these, 43 (5.3%) were aged ≥60 years (ABPA‐elderly). There was a trend towards lower median (interquartile range [IQR]) serum total IgE (4900 [2659‐10000] vs. 7156 [23360‐11963] IU/mL; P =.06) and Aspergillus fumigatus‐specific IgE (12.3 [4.8‐29.6] vs. 22.4 [7.7‐41.5] kUA/L; P =.06) in the elderly than the non‐elderly. Eosinophil counts were similar in the two groups. The median [IQR] number of segments involved by bronchiectasis (5 [2‐9] vs. 7 [4‐11]) was significantly lower in the ABPA‐elderly (P =.001). The proportion of subjects experiencing ABPA exacerbations was significantly (P =.047) lower in the elderly (25.6%) vs. the non‐elderly (40.8%). There was also a tendency towards a lower mean number of exacerbations in the elderly (155 vs. 208 exacerbation per 1000 person‐years) than the non‐elderly (P =.09). There was also a trend towards longer mean time to first exacerbation in the ABPA‐elderly than the non‐elderly (1612 vs. 1159 days). Conclusion: ABPA was uncommon in the elderly. The bronchiectasis is less extensive with a trend towards lower immunological severity and fewer exacerbations in the elderly than the non‐elderly subjects with ABPA.
- Subjects
PULMONARY aspergillosis; OLDER people; EPIDEMIOLOGY; ASPERGILLOSIS; DISEASE exacerbation; BRONCHIECTASIS; EOSINOPHILIA
- Publication
Mycoses, 2022, Vol 65, Issue 1, p71
- ISSN
0933-7407
- Publication type
Article
- DOI
10.1111/myc.13388