High incidence of false-positive Aspergillus galactomannan test in multiple myeloma.
Invasive aspergillosis (IA) remains one of the most significant causes of morbidity and mortality in patients with hematological malignancies undergoing chemotherapy and hematopoietic stem cell transplantation (HSCT), mainly due to the difficulty in its early diagnosis. Monitoring of galactomannan (GM) antigen, an exoantigen of Aspergillus, in the blood by sandwich ELISA is a useful and noninvasive method for early diagnosis of IA. The GM test has a sensitivity of 67-100% with a specificity of 81-99% in neutropenic patients and allogeneic transplant recipients [1-3]. Although it has been widely used as a diagnostic criterion for IA [4,5], one of the major limitations of this assay is false-positivity, particularly in pediatric patients [1], patients with graft-versus-host disease (GVHD) [6,7], and those taking dietary GM [8,9] or fungus-derived antibiotics, such as piperacillin-tazobactam (PIPC/TAZ) [10-12].
Yasuo
Y
Mori
Yoji
Y
Nagasaki
Kenjiro
K
Kamezaki
Katsuto
K
Takenaka
Hiromi
H
Iwasaki
Naoki
N
Harada
Toshihiro
T
Miyamoto
Yasunobu
Y
Abe
Nobuyuki
N
Shimono
Koichi
K
Akashi
Takanori
T
Teshima
D000658:Amoxicillin / Q000494:pharmacology / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D000946:Antigens, Fungal / Q000097:blood*; D016477:Artifacts; D001228:Aspergillosis / Q000097:blood / Q000175:diagnosis*; D001230:Aspergillus / Q000737:chemistry* / Q000276:immunology / Q000302:isolation & purification; D005189:False Positive Reactions; D005690:Galactose / Q000031:analogs & derivatives; D006402:Hematologic Diseases / Q000097:blood*; D019337:Hematologic Neoplasms / Q000097:blood; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008351:Mannans / Q000097:blood*; D009101:Multiple Myeloma / Q000097:blood* / Q000188:drug therapy; D009194:Myeloma Proteins / Q000032:analysis; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D010878:Piperacillin / Q000494:pharmacology / Q000627:therapeutic use; D000077725:Piperacillin, Tazobactam Drug Combination; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D000946:Antigens, Fungal; D007074:Immunoglobulin G; D008351:Mannans; D009194:Myeloma Proteins; C012990:galactomannan; D000077725:Piperacillin, Tazobactam Drug Combination; D000658:Amoxicillin; D010397:Penicillanic Acid; D010878:Piperacillin; D005690:Galactose