title: A clinical evaluation of definitive and clinical allergic bronchopulmonary mycosis.
abstract: OBJECTIVE
  The present study aims to overcome problems associated with the early diagnosis of allergic bronchopulmonary mycosis (ABPM) using the current criteria.
  
  
  METHODS
  Clinical features including radiographic findings from 10 patients with definitive ABPM based on the diagnostic criteria of Rosenberg-Patterson were compared with those from 9 patients with ABPM clinically diagnosed by respiratory allergy specialists.
  
  
  RESULTS
  ABPM should be considered in patients with peripheral blood eosinophilia and pulmonary infiltration and/or central bronchiectasis when serum total IgE is elevated. Complication by bronchial asthma suggested ABPM, but was not essential. The expectoration of sputum containing solid components was a critical factor in patients with a history in ABPM. Evaluation of sputum cultures, serum specific IgE antibodies, skin tests and precipitating antibodies were required to establish a diagnosis, but the positive rate of these tests remained low.
  
  
  CONCLUSIONS
  Even when a definitive diagnosis cannot be established, systemic corticosteroid therapy should be initiated for clinically diagnosed ABPM to prevent irreversible pulmonary dysfunction.
authors.affiliation: Second Department of Internal Medicine, Nagasaki University School of Medicine, Sakamoto.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Matsuse
authors.forename: Hiroko
authors.initials: H
authors.lastname: Nakata
authors.forename: Susumu
authors.initials: S
authors.lastname: Fukahori
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tsuchida
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kawano
authors.forename: Shinya
authors.initials: S
authors.lastname: Tomari
authors.forename: Chizu
authors.initials: C
authors.lastname: Fukushima
authors.forename: Nobuko
authors.initials: N
authors.lastname: Matsuo
authors.forename: Sadahiro
authors.initials: S
authors.lastname: Asai
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001183:Arthus Reaction; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D001987:Bronchiectasis / Q000382:microbiology; D016009:Chi-Square Distribution; D004802:Eosinophilia / Q000382:microbiology; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013183:Sputum / Q000382:microbiology
chemical_list: D015415:Biomarkers; D007073:Immunoglobulin E