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Cut-off values of serum IgE (total and A. fumigatus -specific) and eosinophil count in differentiating allergic bronchopulmonary aspergillosis from asthma.
[allergic bronchopulmonary aspergillosis]
The
cut-off
values
of
immunological
tests
employed
in
diagnosis
of
allergic
bronchopulmonary
aspergillosis
(
ABPA
)
have
never
been
validated
.
Herein
,
we
compare
the
immunological
findings
in
patients
with
ABPA
and
asthma
using
receiver
operating
characteristic
analysis
.
Consecutive
asthmatic
subjects
underwent
all
the
following
investigations
:
Aspergillus
skin
test
,
IgE
levels
(
total
and
A
.
Â
fumigatus-
specific
)
,
Aspergillus
precipitins
,
eosinophil
count
,
chest
radiograph
and
CT
chest
.
There
were
372
subjects
(
179
men
,
mean
age
35
.
9
Â
years
)
with
a
mean
asthma
duration
of
8
Â
years
.
ABPA
was
diagnosed
in
76
patients
(
64
bronchiectasis
,
12
without
bronchiectasis
)
.
ABPA
was
separated
from
asthma
using
the
best
cut-off
values
of
total
IgE
,
A
.
Â
fumigatus
IgE
and
total
eosinophil
count
of
Â
2347
Â
IU
Â
ml
(
-
1
)
,
1
.
91
Â
kUA
Â
l
(
-
1
)
and
507
cells
per
μl
respectively
.
The
sensitivity
/
specificity
of
these
parameters
were
87
/
81
%
;
99
/
87
%
;
and
,
79
/
76
%
respectively
.
The
corresponding
AUC
values
were
0
.
95
,
0
.
90
and
0
.
82
respectively
.
The
combination
of
these
three
tests
at
the
aforementioned
cut-offs
provided
100
%
specificity
.
Our
study
provides
evidence-based
cut-off
values
of
IgE
(
total
and
A
.
Â
fumigatus-
specific
)
and
eosinophil
counts
in
differentiating
ABPA
from
asthma
.
As
this
is
a
single
centre
retrospective
study
,
further
studies
from
different
centres
are
required
,
as
these
values
could
vary
by
ethnicity
and
environmental
exposure
.
Diseases
Validation
Diseases presenting
"asthma"
symptom
allergic bronchopulmonary aspergillosis
cutaneous mastocytosis
erdheim-chester disease
familial hypocalciuric hypercalcemia
lamellar ichthyosis
lymphangioleiomyomatosis
pendred syndrome
This symptom has already been validated