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A random Abstract
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Novel immunologic classification of aspergillosis in adult cystic fibrosis.
[allergic bronchopulmonary aspergillosis]
Patients
with
cystic
fibrosis
(
CF
)
demonstrate
a
wide
range
of
hypersensitivity
responses
to
Aspergillus
,
beyond
allergic
bronchopulmonary
aspergillosis
,
which
require
classification
.
This
study
integrated
2
new
methods
of
Aspergillus
detection-sputum
galactomannan
(
GM
)
and
real-time
PCR-alongside
established
serologic
markers
,
to
reclassify
aspergillosis
in
CF
.
A
total
of
146
adult
patients
with
CF
had
serologic
tests
(
ImmunoCap
total
IgE
,
specific
Aspergillus
fumigatus
IgE
,
and
specific
A
fumigatus
IgG
)
,
sputum
real-time
Aspergillus
PCR
,
and
sputum
GM
.
Patients
were
classified
by
using
latent
class
analysis
.
Both
RT-PCR
and
GM
were
more
sensitive
than
culture
in
detecting
Aspergillus
in
sputum
(
culture
37
%
,
RT-PCR
74
%
,
and
GM
46
%
)
.
Intraassay
and
interassay
reproducibility
of
PCR
and
GM
was
excellent
.
Latent
class
analysis
of
triazole-naive
patients
identified
a
nondiseased
group
and
3
disease
classes
:
class
1
(
n
=
49
,
37
.
7
%
)
represented
patients
with
or
without
positive
RT-PCR
but
no
immunologic
response
to
A
fumigatus
and
negative
GM
(
nondiseased
)
;
class
2
(
n
=
23
,
17
.
7
%
)
represented
patients
with
positive
RT-PCR
,
elevated
total
and
specific
A
fumigatus
IgE
/
IgG
,
and
positive
GM
(
serologic
allergic
bronchopulmonary
aspergillosis
)
;
class
3
(
n
=
19
,
14
.
6
%
)
represented
patients
with
or
without
positive
RT-PCR
,
elevated
A
fumigatus
IgE
(
not
IgG
)
,
and
negative
GM
(
Aspergillus
sensitized
)
;
and
class
4
(
n
=
39
,
30
%
)
represented
patients
with
positive
RT-PCR
,
elevated
A
fumigatus
IgG
(
not
IgE
)
,
and
positive
GM
(
Aspergillus
bronchitis
)
.
Three
distinct
classes
of
aspergillosis
in
CF
were
identified
by
latent
class
analysis
by
using
serologic
,
RT-PCR
,
and
GM
data
.
This
novel
classification
will
facilitate
improved
phenotyping
,
pathogenesis
studies
,
and
management
evaluations
.
Diseases
Validation
Diseases presenting
"wide range"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
adrenomyeloneuropathy
alexander disease
allergic bronchopulmonary aspergillosis
alpha-thalassemia
aromatase deficiency
benign recurrent intrahepatic cholestasis
cadasil
carcinoma of the gallbladder
congenital toxoplasmosis
cowden syndrome
cystinuria
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
fabry disease
gm1 gangliosidosis
harlequin ichthyosis
homocystinuria without methylmalonic aciduria
hydrocephalus with stenosis of the aqueduct of sylvius
legionellosis
neonatal adrenoleukodystrophy
oral submucous fibrosis
pendred syndrome
phenylketonuria
pleomorphic liposarcoma
primary effusion lymphoma
primary hyperoxaluria type 1
proteus syndrome
pyruvate dehydrogenase deficiency
scrub typhus
systemic capillary leak syndrome
thoracic outlet syndrome
triple a syndrome
trochlear dysplasia
well-differentiated liposarcoma
werner syndrome
x-linked adrenoleukodystrophy
zellweger syndrome
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