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European Journal of Pediatrics

, Volume 164, Issue 9, pp 577–582 | Cite as

Risk factors for allergic bronchopulmonary aspergillosis and sensitisation to Aspergillus fumigatus in patients with cystic fibrosis

  • Nicole Ritz
  • Roland A. Ammann
  • Carmen Casaulta Aebischer
  • Franziska Schoeni-Affolter
  • Martin H. SchoeniEmail author
Original Paper

Abstract

An increasing incidence of allergic bronchopulmonary aspergillosis (ABPA) as a complication in patients with cystic fibrosis (CF) is reported. The objective of this retrospective case-control study was to assess potential risk factors for ABPA and for Aspergillus fumigatus sensitisation (AFS). In a group of 160 CF patients, 11 (7%) fulfilled the diagnostic criteria for ABPA and 20 (13%) had evidence of AFS. They were compared to 62 control CF patients (25 for ABPA and 37 for AFS group) without evidence of ABPA or AFS using extended matching for sex, age and weight. AFS patients had received significantly higher cumulative doses of inhaled corticosteroids than their respective controls (OR 8.0; 95% CI 1.74–63). Bronchial colonisation with Stenotrophomonas maltophilia was strongly and independently associated with ABPA (OR 20; 95% CI 2.8– infinity). A longer duration of Pseudomonas aeruginosa colonisation was independently associated with AFS (OR per year 1.50; 95% CI 1.12– infinity). Conclusion: Cystic fibrosis patients with allergic bronchopulmonary aspergillosis have a more frequent isolation of S. maltophilia in their sputum than their controls. Longer duration of colonisation with P. aeruginosa is a risk factor for Aspergillus fumigatus sensitisation. Higher cumulative doses of inhaled corticosteroids are associated with Aspergillus fumigatus sensitisation and their role as a risk factor needs to be clarified.

Keywords

Allergic bronchopulmonary aspergillosis  Aspergillus fumigatus Cystic fibrosis Recombinant Aspergillus fumigatus antigen  Stenotrophomonas maltophilia 

Abbreviations

ABPA

allergic bronchopulmonary aspergillosis

AFS

Aspergillus fumigatus sensitisation

BMI

body mass index

CF

cystic fibrosis

CFTR

cystic fibrosis transmembrane regulator

IQR

interquartile range

rAsp f

recombinant Aspergillus fumigatus antigen

Notes

Acknowledgements

We thank Prof. Dr. Kurt Blaser and Prof. Dr. Reto Crameri from the Swiss Institute for Allergy and Asthma Research (SIAF), Davos, for determining specific IgG and IgE against rAsp f in the sera of the CF patients. Carmen Casaulta Aebischer was supported by a grant from the Silva Casa Foundation, Berne, Switzerland and Franziska Schoeni-Affolter by a grant from Roche Pharma (Schweiz), Switzerland.

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Nicole Ritz
    • 1
  • Roland A. Ammann
    • 1
  • Carmen Casaulta Aebischer
    • 1
  • Franziska Schoeni-Affolter
    • 2
  • Martin H. Schoeni
    • 1
    Email author
  1. 1.Department of PaediatricsUniversity of BerneBerne Switzerland
  2. 2.Department of EmbryologyUniversity of FribourgFribourg Switzerland

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