Frequency of familial occurrence in 164 patients with allergic bronchopulmonary aspergillosis

Background: Asthma is known to run in families. Allergic bronchopulmonary aspergillosis (ABPA) occurs predominantly in patients with asthma. However, there are only 6 reports of familial occurrence over a period of 35 years. Objective: To determine the frequency of familial occurrence in 164 patients with ABPA diagnosed over a period of 22 years in one unit. Methods: The 164 patients with ABPA were reviewed for the occurrence of familial ABPA. Symptomatic family members were evaluated for the presence of ABPA as well as allergic Aspergillus sinusitis (AAS). Allergic bronchopulmonary aspergillosis and AAS were diagnosed as per criteria established. Results: Of the 164 patients with ABPA, familial occurrence was detected in 4 pairs of first degree relatives, 2 of whom were parent-child while the other 2 were siblings. Familial ABPA was seen in 4.9% of the total patients. Of these 8 patients seven had symptoms of rhinitis while 4 had sinusitis confirmed on computed tomography of paranasal sinuses. Allergic Aspergillus sinusitis was detected in 3 of these 4 patients. The fourth patient with sinusitis did not consent to surgery required to confirm the diagnosis. Five of our 8 patients, prior to referral, had received antituberculous therapy. All patients responded favourably to oral prednisolone. Conclusion: Familial occurrence was documented in 4.9% of the 164 patients with ABPA.