Diagnostic Differences Between Allergic Bronchopulmonary Aspergillosis and Chronic Eosinophilic Pneumonia

In Uzbekistan, the differentiation between allergic bronchopulmonary aspergillosis (ABPA) and chronic eosinophilic pneumonia (CEP) is challenging due to limited data and similar clinical presentations. Both conditions show peripheral eosinophilia, leading to frequent misdiagnosis. This study aimed to investigate the clinical and radiographic differences between ABPA and CEP-like presentations to improve diagnosis in Uzbekistan. A retrospective analysis of 25 patients with ABPA from 2015 to 2019 was conducted. Patients were grouped based on high-resolution computed tomography (HRCT) findings: those with CEP-like features and those with typical ABPA. Clinical and immunologic data were compared. Results showed that while both groups had similar eosinophil counts and Aspergillus-specific immunoglobulin E (IgE) levels, only the non-CEP group showed a significant correlation between eosinophils and IgE. The non-CEP group also had higher levels of the fungal marker beta-D glucan. Recurrence rates were high, but no progression from CEP-like to typical ABPA was observed. These findings emphasize the importance of Aspergillus-specific IgE testing for accurate diagnosis and management of pulmonary eosinophilia in Uzbekistan, potentially preventing misdiagnosis and improving patient outcomes.