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Should Aspergillus screening before bronchial thermoplasty?

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Thank you for your feedback. If there were any findings suspicious of allergic bronchopulmonary Aspergillosis (ABPA), aspergillus-specific antibody measurements and skin tests would have been performed as screening [1]. However, this case did not show any findings considered to be ABPA such as bronchodilation and mucus plugs on computed tomography (CT) and bronchoscopy before treatment [2]. On the other hand, regarding the sessions of bronchial thermoplasty (BT) for severe asthma, the third session was performed after the sample was collected, so BT treatment was completed. Regarding BT indications, although regular steroid administration was not performed in this case, a single rescue steroid administration was performed, and it is judged to be within the indication in Japan.

The question is, do you order Aspergillus-specific antibodies or skin tests on all cases of asthma that are not abnormal on CT and bronchoscopy?

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Abbreviations

ABPA:

Allergic bronchopulmonary Aspergillosis

BT:

Bronchial thermoplasty

CT:

Computed tomography

References

  1. 1.

    Asano K, Hebisawa A, Ishiguro T, et al. New clinical diagnostic criteria for allergic bronchopulmonary Aspergillosis/mycosis and its validation. J Allergy Clin Immunol. 2021;147:1261-1268.e5. https://doi.org/10.1016/j.jaci.2020.08.029.

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  2. 2.

    Sasada S, Ohmura K, Oguri T, et al. A case report of Aspergillosis accompanied by saccular bronchodilation after bronchial thermoplasty in a 19-year-old woman. BMC Pulm Med. 2020;20:312. https://doi.org/10.1186/s12890-020-01352y.

    Article  PubMed  PubMed Central  Google Scholar 

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S. S. significantly contributed to this paper.

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Correspondence to Shinji Sasada.

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Sasada, S. Should Aspergillus screening before bronchial thermoplasty?. BMC Pulm Med 21, 195 (2021). https://doi.org/10.1186/s12890-021-01536-0

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Keywords

  • Allergic bronchopulmonary Aspergillosis
  • Bronchial thermoplasty
  • Severe asthma