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P249 Predictors of adverse outcome in sarcoidosis complicated by chronic pulmonary aspergillosis

Title: P249 Predictors of adverse outcome in sarcoidosis complicated by chronic pulmonary aspergillosis
Authors: Nwankwo, Lisa; Periselneris, Jimstan; Gilmartin, Desmond; Desai, Sujal; Shah, Anand; Kouranos, Vasilis; Renzoni, Elisabetta; Wells, Athol; Molyneaux, Phil; George, Peter; Kokosi, M.; Devaraj, Anand; Armstrong-James, Darius; Chua, Felix
Source: Medical Mycology ; volume 60, issue Supplement_1 ; ISSN 1369-3786 1460-2709
Publisher Information: Oxford University Press (OUP)
Publication Year: 2022
Description: 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
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/mmy/myac072.p249
Availability: https://doi.org/10.1093/mmy/myac072.p249; https://academic.oup.com/mmy/article-pdf/60/Supplement_1/myac072P249/46444909/myac072.p249.pdf
Rights: https://creativecommons.org/licenses/by-nc-nd/4.0/
Accession Number: edsbas.68C2D082
Database: BASE