TY - JOUR T1 - Clinical characteristics and outcomes of patients with Mycobacterium avium complex lung disease positive for Aspergillus precipitating antibody JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2019.PA2940 VL - 54 IS - suppl 63 SP - PA2940 AU - Tatsuya Shirai AU - Koji Furuuchi AU - Kozo Morimoto AU - Keiji Fujiwara AU - Keitaro Nakamoto AU - Yoshiaki Tanaka AU - Yuka Sasaki AU - Kozo Yoshimori AU - Haruyuki Ishii AU - Ken Ohta Y1 - 2019/09/28 UR - http://erj.ersjournals.com/content/54/suppl_63/PA2940.abstract N2 - Background: Chronic pulmonary aspergillosis (CPA) is associated with mortality in patients with Mycobacterium avium complex lung disease (MAC-LD). However, the clinical significance of the positivity of Aspergillus precipitating antibody (APAb), a serodiagnostic test for pulmonary aspergillosis (PA), at the time of MAC-LD diagnosis is unknown. The objective of this study was to investigate the clinical characteristics and outcomes of patients with MAC-LD positive for APAb.Methods: We retrospectively analyzed patients who were newly diagnosed with MAC-LD between 2007 and 2014 in our hospital and checked for APAb within one month of diagnosis.Results: We enrolled 131 patients in this study. Of these patients, 20 (15.3%) tested positive for APAb at diagnosis of MAC-LD. APAb-positive patients were more frequently male (70.0% vs. 37.8%, P = 0.013) and more frequently had pulmonary emphysema (60.0% vs. 13.5%, P < 0.01) and interstitial pneumonia (15.0% vs. 1.8%, P = 0.025) compared with APAb-negative patients. During a median follow-up period of 4.0 years, PA developed in 12 APAb-positive patients (60.0%, 9 CPA and 3 allergic bronchopulmonary aspergillosis cases) and 12 APAb-negative patients (10.8%, 12 CPA cases) (P < 0.01). APAb-positive patients had a significantly higher rate of mortality than did APAb-negative patients (P < 0.01). A multivariate analysis indicated that older age, lower albumin, fibrocavitary or fibrocavitary + nodular/bronchiectatic radiographic features, and APAb positivity were negative prognostic factors.Conclusions: APAb-positive MAC-LD patients more frequently develop PA and may have an unfavorable prognosis.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA2940.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -