PT  - JOURNAL ARTICLE
AU  - Maignant, Annefleur
AU  - Mellot, François
AU  - Haudebourg, Luc
AU  - Neveu, Helene
AU  - Rivaud, Elisabeth
AU  - Catherinot, Emilie
AU  - Bron, Camille
AU  - Salvator, Helene
AU  - Chabrol, Alexandre
AU  - Anitei, Oana
AU  - Trebbia, Gregoire
AU  - Devaquet, Jerome
AU  - Cerf, Charles
AU  - Couderc, Louis-Jean
AU  - Tcherakian, Colas
TI  - Allergic bronchopulmonary aspergillosis complicating COPD is associated with a higher exacerbation rate and a distinct pattern on chest CT scan compared to COPD
AID  - 10.1183/13993003.congress-2016.PA4195
DP  - 2016 Sep 01
TA  - European Respiratory Journal
PG  - PA4195
VI  - 48
IP  - suppl 60
4099  - https://publications.ersnet.org//content/48/suppl_60/PA4195.short
4100  - https://publications.ersnet.org//content/48/suppl_60/PA4195.full
SO  - Eur Respir J2016 Sep 01; 48
AB  - Recent data support that patients with COPD can experienced associated asthma in an overlap syndrome. This raise hypothesis of specific complications in these patients as allergic broncho-pulmonary aspergillosis (ABPA), usually seen in asthma patients, exhibiting potential specific features when associated to COPD. We compiled 16 cases of ABPA (Patterson criteria) diagnosed in COPD patients (GOLD criteria,Tabaco > 10 PY) in a monocentrique retrospective study, then compared to 16 COPD matched patients on age and FEV1, with similar overall follow up (7.8 years). ABPA-COPD group age was 61.1 years, FEV1 was 36% (1127mL), tobacco consumption was 46.6 PY and 8 out of 16 had known asthma in childhood. ABPA diagnosis was done 6 years after COPD diagnosis. All patients were investigated for specific IgE=19,4 kUI/l, IgE=2684 kUI/l, eosinophilia=1271/mm3. 13/16 had positive IgG, 10 had Aspergillus in sputum. Immediate prick test was positive in 6 out of 7 patients. All received inhaled and oral steroids, 13 patients received oral fungicide and 7 omalizumab. When compared to COPD group, ABPA-BPCO group exhibits higher loss of FEV1 (-83,16 vs -31,14mL/year;p= 0.04). A higher hospitalization rate for exacerbation (1.69 vs 0.53/year;p=0,0007). Using Bhalla scoring, chest CT scan exhibits higher severity in bronchiectasis, mucoid impaction extension but not emphysema (p=0,002; p=0,03; p=0,45) as well as overall extent (10,12 vs 6.8;p= 0,003) ABPA-COPD exhibits a specific pattern and must be considered in COPD patients with recurring exacerbations. CT is distinguishing for diagnosis, in association with biological tools.