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Uncertain areas in the diagnosis of allergic bronchopulmonary aspergillosis in patients with asthma.
[allergic bronchopulmonary aspergillosis]
The
prevalence
of
allergic
bronchopulmonary
aspergillosis
(
ABPA
)
in
patients
with
bronchial
asthma
remains
unknown
.
We
evaluated
the
roles
of
various
laboratory
tests
in
the
diagnosis
of
ABPA
,
including
,
skin
prick
test
(
SPT
)
for
Aspergillus
fumigatus
(
Af
)
,
and
serum
Af
specific
IgE
and
IgG
antibody
measurement
.
A
total
of
50
asthma
patients
with
more
than
1000
cell
/
μL
of
peripheral
blood
eosinophils
were
prospectively
collected
between
January
2007
and
September
2011
.
Evaluations
using
SPT
for
Af
,
serum
total
IgE
and
specific
IgE
antibody
to
Af
by
CAP
system
,
IgG
antibody
to
Af
by
enzyme
immunoassay
(
EIA
)
or
CAP
system
were
performed
according
to
the
essential
minimal
criteria
for
the
diagnosis
of
ABPA
-
asthma
,
immediate
cutaneous
reactivity
to
Af
,
elevated
total
IgE
,
and
raised
Af
specific
IgE
and
IgG
.
Among
50
patients
,
three
patients
(
6
.
0
%
)
were
diagnosed
as
ABPA
,
of
whom
each
confirmed
five
items
of
the
essential
minimal
diagnostic
criteria
for
the
diagnosis
of
ABPA
.
Six
patients
(
12
.
0
%
)
showed
negative
responses
to
Af
in
SPT
,
but
positive
responses
in
specific
IgE
by
CAP
system
.
Eight
patients
(
16
.
0
%
)
showed
negative
responses
to
IgG
to
Af
by
CAP
system
,
but
positive
responses
by
enzyme
immunoassay
(
EIA
)
.
SPT
and
serum
IgE
to
Af
measurement
by
CAP
system
should
be
performed
simultaneously
.
It
is
reasonable
to
set
up
cut-off
values
in
Af
specific
IgE
/
IgG
by
CAP
system
for
the
differentiation
of
ABPA
from
Af
sensitised
asthma
patients
.
Diseases
Validation
Diseases presenting
"bronchial asthma"
symptom
allergic bronchopulmonary aspergillosis
lymphangioleiomyomatosis
pendred syndrome
This symptom has already been validated
