title: Uncertain areas in the diagnosis of allergic bronchopulmonary aspergillosis in patients with asthma.
abstract: OBJECTIVE
  The prevalence of allergic bronchopulmonary aspergillosis (ABPA) in patients with bronchial asthma remains unknown. We evaluated the roles of various laboratory tests in the diagnosis of ABPA, including, skin prick test (SPT) for Aspergillus fumigatus (Af), and serum Af specific IgE and IgG antibody measurement.
  
  
  METHODS
  A total of 50 asthma patients with more than 1000cell/μL of peripheral blood eosinophils were prospectively collected between January 2007 and September 2011. Evaluations using SPT for Af, serum total IgE and specific IgE antibody to Af by CAP system, IgG antibody to Af by enzyme immunoassay (EIA) or CAP system were performed according to the essential minimal criteria for the diagnosis of ABPA - asthma, immediate cutaneous reactivity to Af, elevated total IgE, and raised Af specific IgE and IgG.
  
  
  RESULTS
  Among 50 patients, three patients (6.0%) were diagnosed as ABPA, of whom each confirmed five items of the essential minimal diagnostic criteria for the diagnosis of ABPA. Six patients (12.0%) showed negative responses to Af in SPT, but positive responses in specific IgE by CAP system. Eight patients (16.0%) showed negative responses to IgG to Af by CAP system, but positive responses by enzyme immunoassay (EIA).
  
  
  CONCLUSIONS
  SPT and serum IgE to Af measurement by CAP system should be performed simultaneously. It is reasonable to set up cut-off values in Af specific IgE/IgG by CAP system for the differentiation of ABPA from Af sensitised asthma patients.
authors.affiliation: Department of Internal Medicine, College of Medicine, Dong-A University, Busan, South Korea.
authors.forename: M R
authors.initials: MR
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, College of Medicine, Dong-A University, Busan, South Korea.
authors.forename: Y H
authors.initials: YH
authors.lastname: Nam
authors.affiliation: Department of Internal Medicine, College of Medicine, Dong-A University, Busan, South Korea. Electronic address: skleeai@dau.ac.kr.
authors.forename: S K
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Laboratory Medicine, College of Medicine, Dong-A University, Busan, South Korea.
authors.forename: K H
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Anatomic Pathology, College of Medicine, Dong-A University, Busan, South Korea.
authors.forename: M S
authors.initials: MS
authors.lastname: Roh
authors.affiliation: Department of Internal Medicine, College of Medicine, Dong-A University, Busan, South Korea.
authors.forename: H W
authors.initials: HW
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, College of Medicine, Dong-A University, Busan, South Korea.
authors.forename: I H
authors.initials: IH
authors.lastname: Jeong
authors.affiliation: Department of Internal Medicine, College of Medicine, Dong-A University, Busan, South Korea.
authors.forename: S J
authors.initials: SJ
authors.lastname: Um
authors.affiliation: Department of Internal Medicine, College of Medicine, Dong-A University, Busan, South Korea.
authors.forename: C H
authors.initials: CH
authors.lastname: Son
mesh_terms: D000328:Adult; D000368:Aged; D000908:Antibodies, Fungal / Q000097:blood; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology*; D001249:Asthma / Q000150:complications*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012882:Skin Tests; D055815:Young Adult
chemical_list: D000908:Antibodies, Fungal; D007074:Immunoglobulin G; D007073:Immunoglobulin E
keywords: Allergic bronchopulmonary; Aspergillosis; Asthma; Diagnosis; Skin tests