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The prevalence of increased serum IgE and Aspergillus sensitization in patients with COPD and their association with symptoms and lung function.
[allergic bronchopulmonary aspergillosis]
Allergy
and
Aspergillus
hypersensitivity
(
AH
)
were
shown
to
be
associated
with
severe
symptoms
or
worse
lung
function
in
COPD
patients
.
The
prevalence
of
elevated
total
IgE
(
T
-IgE
)
and
its
association
with
clinical
symptoms
and
lung
function
in
COPD
have
not
been
studied
.
The
prevalence
of
AH
and
its
correlation
with
clinical
characteristics
in
a
COPD
cohort
of
larger
sample
size
is
also
lacking
.
273
patients
with
COPD
were
evaluated
by
respiratory
symptoms
,
blood
test
,
chest
HRCT
,
lung
function
,
serum
detection
of
T
-IgE
and
Aspergillus
specific
IgE
.
Patients
with
T
-IgE
 
≥
 
1000
KU
/
L
were
further
investigated
for
allergic
bronchopulmonary
aspergillosis
(
ABPA
)
.
The
prevalence
of
elevated
T
-IgE
and
AH
in
patients
with
COPD
was
47
.
3
%
and
15
.
0
%
,
respectively
.
Eight
patients
(
2
.
9
%
)
met
the
diagnostic
criteria
for
ABPA
.
Compared
with
the
normal
T
-IgE
group
,
patients
with
elevated
T
-IgE
had
a
longer
history
of
dyspnea
(
p
<
0
.
01
)
,
an
earlier
onset
of
dyspnea
after
chronic
cough
/
expectoration
(
p
<
0
.
01
)
,
and
were
more
likely
to
wheeze
(
p
<
0
.
01
)
.
They
also
showed
worse
lung
functions
and
more
severe
GOLD
staging
(
p
<
0
.
01
)
.
Analysis
of
the
clinical
data
in
male
patients
with
smoking
as
the
risk
factor
showed
the
same
results
.
To
evaluate
the
clinical
characteristics
of
COPD
with
AH
,
patients
with
elevated
T
-IgE
were
further
divided
into
subgroups
with
and
without
AH
.
When
compared
with
the
normal
T
-IgE
group
,
both
the
two
subgroups
showed
longer
history
of
dyspnea
(
p
<
0
.
01
)
,
an
earlier
onset
of
dyspnea
(
p
<
0
.
01
)
and
a
worse
status
of
lung
function
(
p
<
0
.
05
)
.
Correlation
analysis
demonstrated
that
T
-IgE
was
correlated
positively
with
the
time
length
of
dyspnea
(
r
=
0
.
401
,
p
<
0
.
001
)
,
and
the
ratio
of
duration
of
dyspnea
to
that
of
chronic
cough
/
expectoration
(
r
=
0
.
59
,
p
<
0
.
001
)
,
but
negatively
with
FEV
1
/
FVC
%
(
r
=
-
0
.
194
,
p
=
0
.
001
)
,
and
FEV
1
%
predicted
(
r
=
-
0
.
219
,
p
<
0
.
001
)
.
There
was
a
high
prevalence
of
elevated
serum
T
-IgE
and
AH
in
patients
with
COPD
.
Serum
T
-IgE
level
was
correlated
with
symptoms
such
as
dyspnea
and
impairment
of
lung
function
.
Allergens
other
than
Aspergillus
may
have
similar
effects
on
disease
expression
or
progression
of
COPD
.
Diseases
Validation
Diseases presenting
"allergy"
symptom
acute rheumatic fever
allergic bronchopulmonary aspergillosis
cutaneous mastocytosis
fabry disease
heparin-induced thrombocytopenia
kabuki syndrome
severe combined immunodeficiency
systemic capillary leak syndrome
waldenström macroglobulinemia
wiskott-aldrich syndrome
This symptom has already been validated