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Abstract

Background: Allergic bronchopulmonary aspergillosis (ABPA) is a Th2-mediated pulmonary disorder triggered by Aspergillus fumigatus, primarily affecting individuals with bronchial asthma and allergic rhinitis. Characterized by eosinophilia, elevated IgE levels, and structural lung abnormalities, ABPA remains underdiagnosed, especially in resource-constrained settings, resulting in progressive airway damage and long-term morbidity.
Aim and Objectives: This study aimed to evaluate the prevalence of ABPA among patients with asthma and allergic rhinitis at a tertiary care centre. Specific objectives included assessment of hypersensitivity using skin prick testing (SPT), evaluation of immunological markers through ELISA, and correlation of seropositivity with radiological findings.
Materials and Methods: An observational study was conducted from May 2023 to November 2024 at the Integral Institute of Medical Sciences and Research, enrolling 160 patients with clinically diagnosed asthma and/or allergic rhinitis. All participants underwent SPT using Aspergillus fumigatus antigens. Peripheral eosinophilia was assessed via differential leukocyte count and absolute eosinophil count (AEC). Serum total IgE, and A. fumigatus-specific IgE and IgG levels were determined using ELISA. Chest radiographic evaluation and contrast-enhanced computed tomography (CECT) were performed in selected cases.
Results: Of the 160 patients, bronchial asthma was diagnosed in 47.05%, allergic rhinitis in 28.75%, and both conditions in 23.75%. SPT positivity was observed in 58.1% of cases, with a higher rate among females (67.69%). Elevated AEC was noted in 73% of patients. Among 77 SPT-positive individuals undergoing CECT, 90.9% showed abnormal findings—predominantly bronchiectasis (26%) and pulmonary opacity (23.4%). ELISA revealed A. fumigatus-specific IgE in 15.05% and specific IgG in 13.98% of SPT-positive patients. Elevated total IgE was observed in 19.35%, predominantly in asthma cases. These findings indicate a significant burden of ABPA-related immunological and radiological markers in patients with allergic airway diseases.