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 . fumigatus-specific ), Aspergillus precipitins , eosinophil count , chest radiograph and CT chest . There were 372 subjects (179 men , mean age 35 .9 years ) with a mean asthma duration of 8 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 . fumigatus IgE and total eosinophil count of 2347 IU ml (-1 ) , 1 .91 kUA 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 . 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 "single centre retrospective study" symptom

allergic bronchopulmonary aspergillosis

carcinoma of the gallbladder

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