P249 Predictors of adverse outcome in sarcoidosis complicated by chronic pulmonary aspergillosis
| العنوان: | P249 Predictors of adverse outcome in sarcoidosis complicated by chronic pulmonary aspergillosis |
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| المؤلفون: | Lisa Nwankwo, Jimstan Periselneris, Desmond Gilmartin, Sujal Desai, Anand Shah, Vasilis Kouranos, Elisabetta Renzoni, Athol Wells, Phil Molyneaux, Peter George, M. Kokosi, Anand Devaraj, Darius Armstrong-James, Felix Chua |
| المصدر: | Medical Mycology. 60 |
| بيانات النشر: | Oxford University Press (OUP), 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Infectious Diseases, General Medicine |
| الوصف: | Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Introduction Aspergillosis complicating pulmonary sarcoidosis is associated with high mortality.1 The specific prognostic impact of fibrocavitary sarcoid disease, however, remains poorly understood. A better understanding of the factors that determine adverse outcomes in such patients may improve the management of both the underlying sarcoid disease and associated secondary fungal infection. Methods We implemented a clinical informatics pipeline to data-mine the hospital's clinical data warehouse and identify patients for inclusion in this study. Cases of pulmonary sarcoidosis with elevated Aspergillus IgG (>40 mgA/l) presenting between January 2009 and March 2021 were retrospectively identified. Controls (sarcoidosis with normal Aspergillus IgG titer) were case matched by baseline percentage-predicted gas transfer factor (TLco; ±5% variance). CPA cases were identified by using ISHAM criteria for diagnosing CPA, that is Aspergillus IgG >40 mgA/l plus keyword search for cavities or fungal ball in the CT reports based on search terms for aspergilloma, cavity, intra-cavitary, and mycetoma. Computed tomography (CT), baseline lung function, and survival data were analyzed. Results Among 179 cases (high Aspergillus IgG) and 477 controls (normal Aspergillus IgG), no inter-group difference was evident in the median age at presentation [48 (IQR 40-58) vs 50 (IQR 42-59)] or gender (proportion female: 45.5% vs 51.1%). Amongst the cases, 80/179 (45%) had fibrocavitary changes, compared with 14/477 (2.9%) of the controls (P Conclusions Fibrocavitary sarcoidosis is associated with worse lung function and poorer median survival. In this group, elevated Aspergillus IgG highlights a greater incidence of aspergilloma. Implications Fibrotic transformation of pulmonary sarcoidosis heightens symptom burden, predisposes to chronic Aspergillus infection, and is prognostically important particularly when there is supervening fibrocavitary lung destruction. Sensitive stratification of such patients for the long-term outcomes may help identify particular individuals for earlier and more focused therapeutic intervention. Sources |
| تدمد: | 1460-2709 1369-3786 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::ba6780080469a35083a586e395f631e4 https://doi.org/10.1093/mmy/myac072.p249 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi...........ba6780080469a35083a586e395f631e4 |
| قاعدة البيانات: | OpenAIRE |
PDF full text from Publisher | تدمد: | 14602709 13693786 |
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