[Allergic bronchopulmonary aspergillosis (ABPA)].
ABPA is the most common allergic bronchopulmonary mycosis in humans. The diagnosis of the complex disease is based on defined criteria. Five clinical stages of ABPA were proposed. The extend of the defined criteria varies in the different stages, thus making diagnosis difficult. Particularly the discrimination of ABPA in remission stage (stage II) and allergic asthma with A--sensitisation may be an important problem. Early diagnosis in stages without persistent changes of bronchial wall and lung parenchyma is needed to prevent severe end stages of ABPA. The up to now widely used commercial (crude) allergen extracts for in vitro and in vivo diagnosis show batch to batch variation, insufficient standardization and lack of reproducibility. Potentials and limitations of routine diagnostic procedures in ABPA are described. The production of a panel of recombinant allergens of A. fumigatus and their evaluation for in vivo and particularly in vitro use has brought an important step forward in the early and precise diagnosis of ABPA. A panel of recombinant allergens is now available for routine assay in CAP-System.
Menz
G
G
Abteilung Pneumologie II, Hochgebirgsklinik Davos Wolfgang/Schweiz.
Willer
G
G
Crameri
R
R
D000485:Allergens; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000175:diagnosis* / Q000276:immunology / Q000503:physiopathology; D001249:Asthma / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans
D000485:Allergens