The Complications of Aspergillus fumigatus Sensitization in Patients with Asthma

 Two major complications of Aspergillus sensitization in patients with asthma, including severe asthma with fungal sensitization (SAFS) and asthma associated with fungal sensitization (AAFS), have been recently described.

 In the present study, we aimed to evaluate the prevalence of SAFS and AAFS in Iranian patients with asthma.

 Two hundred consecutive outpatients aged ≥ 18 years with moderate to severe allergic asthma, referred to a pulmonary subspecialty hospital (Tehran, Iran) for 25 months, were included in the study. Skin prick test (SPT), total IgE (tIgE), and specific IgE (sIgEAf) and IgG against Aspergillus fumigatus (sIgGAf) were determined for all subjects. Comprehensive criteria were applied for the diagnosis of SAFS and AAFS.

 Of 200 included patients, 103 (51.5%) and 97 (48.5%) were with moderate and severe asthma, respectively. Of these patients, 111 (55.5%) were female. The mean (range) of age was 45.8 (18 - 78) years. Of 200 patients, 27 (13.5%), 22 (11.0%), 114 (57.0%), and 131 (65.5%) were positive for Aspergillus SPT, sIgEAf, sIgGAf, and tIgE, respectively. The overall prevalence of SAFS in patients with severe asthma and AASF in patients with moderate asthma were 7.2% (7/97) and 3.9% (4/103), respectively.

 According to the findings, the prevalence of SAFS and AAFS in Iranian patients with severe and moderate allergic asthma was lower than the previously published global data. This low-prevalence reported rate may be due to the fact that we applied strict criteria in the present study.