Sheng Huang1, Jiao-Li Wang, Li-Min Wang. 1. Department of Respiratory Medicine, Hangzhou First People's Hospital, Hangzhou 310006, China.
Abstract
OBJECTIVE: to describe the clinical features and diagnosis of severe asthma with fungal sensitization (SAFS). METHODS: the clinical data of 3 patients of SAFS from this hospital were presented, and the related literatures reviewed. RESULTS: the 3 patients, 1 male and 2 females, aging 55, 52 and 61 years respectively, had a history of asthma for 4 - 40 years. All of them presented with severe asthma symptoms, and were found to have fungal sensitization by skin prick testing. Their serum IgE level was less than 1000 IU/ml. A. fumigatus was positive from sputum cultures. There were no radiological abnormalities such as pulmonary infiltrates and bronchiectasis by HRCT in all cases. The serum galactomannan (GM) was positive in 2 patients. After diagnosis, they received additional antifungal therapy for 4 - 22 months, respectively, and the prognosis was good. CONCLUSION: SAFS should be considered in patients with severe asthma and sensitization to fungi but without elevation of serum IgE. Adjunctive antifungal therapy is beneficial for asthma control.
OBJECTIVE: to describe the clinical features and diagnosis of severe asthma with fungal sensitization (SAFS). METHODS: the clinical data of 3 patients of SAFS from this hospital were presented, and the related literatures reviewed. RESULTS: the 3 patients, 1 male and 2 females, aging 55, 52 and 61 years respectively, had a history of asthma for 4 - 40 years. All of them presented with severe asthma symptoms, and were found to have fungal sensitization by skin prick testing. Their serum IgE level was less than 1000 IU/ml. A. fumigatus was positive from sputum cultures. There were no radiological abnormalities such as pulmonary infiltrates and bronchiectasis by HRCT in all cases. The serum galactomannan (GM) was positive in 2 patients. After diagnosis, they received additional antifungal therapy for 4 - 22 months, respectively, and the prognosis was good. CONCLUSION:SAFS should be considered in patients with severe asthma and sensitization to fungi but without elevation of serum IgE. Adjunctive antifungal therapy is beneficial for asthma control.