Am. J. Respir. Crit. Care Med., Vol 152, No. 2, Aug 1995, 634-639.
Identification of allergic bronchopulmonary aspergillosis in cystic fibrosis patients by recombinant Aspergillus fumigatus I/a-specific serology
WH Nikolaizik, M Moser, R Crameri, S Little, JO Warner, K Blaser and MH Schoni
Alpine Children's Hospital, Davos, Switzerland.
Before specific therapy, such as oral corticosteroids, can be commenced it
is essential to distinguish full-blown allergic bronchopulmonary
aspergillosis (ABPA) from allergy to A. fumigatus in patients with cystic
fibrosis (CF). For this purpose we have evaluated the diagnostic value of
recombinant A. fumigatus allergen I/a (rAsp f I/a)-specific serology in 55
patients with CF. Based on clinical presentation and laboratory data, 10 CF
patients had ABPA, 27 had Aspergillus allergy, and 18 were not allergic to
A. fumigatus (CF control group). The serologic assays revealed a 10-fold
increase in rAsp fI/a-specific IgE, a 5-fold increase in rAsp fI/a-specific
IgG1, and a 4-fold increase in rAsp fI/a-specific IgG4 antibodies in ABPA
patients compared with the Aspergillus allergy and CF control groups. Sera
from 11 CF patients were analyzed without knowledge of their clinical state
or diagnosis of ABPA. All ABPA patients (4 of 11) were accurately
identified. We conclude that rAsp fI/a-specific serology is a highly
sensitive and specific test that can be used to identify ABPA reliably in
CF patients.
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Copyright © 1995 American Thoracic Society
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