Allergic Bronchopulmonary Aspergillosis in Asthma and Cystic Fibrosis

Table 2

Criteria for diagnosis of allergic bronchopulmonary aspergillosis in cystic fibrosis.

Classic Diagnostic Criteria
(i) Acute or subacute clinical deterioration not attributable to another etiology
(ii) Total serum IgE concentration greater than 1000 IU/mL unless patient is receiving corticosteroid therapy
(iii) Immediate cutaneous reactivity to Aspergillus fumigatus while the patient is not being treated with antihistamines or in vitro presence of serum IgE antibody to A. fumigatus
(iv) Precipitating antibodies or serum IgG antibody to A. fumigatus
(v) New or recent abnormalities on chest radiography or chest CT that have not cleared with antibiotics and standard physiotherapy
Minimal Diagnostic Criteria
(i) Acute or subacute clinical deterioration not attributable to another etiology
(ii) Total serum IgE concentration greater than 500 IU/mL unless patient is receiving corticosteroid therapy. If ABPA is suspected and the total level of 200 to 500 IU/mL, repeat testing in 1 to 3 months is recommended. If patient is taking steroids, repeat when steroid treatment is discontinued.
(iii) Immediate cutaneous reactivity to Aspergillus fumigatus while the patient is not being treated with antihistamines or in vitro presence of serum IgE antibody to A. fumigatus
(iv) One of the following: (a) precipitins to A. fumigatus or in vitro documentation of IgG antibody to A. fumigates, or (b) new or recent abnormalities on chest radiography or chest CT that have not cleared with antibiotics and standard physiotherapy