title: The diagnostic criteria for allergic bronchopulmonary aspergillosis in children with poorly controlled asthma need to be re-evaluated.
abstract: OBJECTIVE
  The aim of this study was to examine the association between allergic bronchopulmonary aspergillosis (ABPA) and poorly controlled asthma in children and appraise the diagnostic criteria.
  
  
  METHODS
  The study included 100 children with poorly controlled asthma. We diagnosed ABPA using the Aspergillus skin test, pulmonary function test, total and specific immunoglobulin E (IgE) to Aspergillus fumigatus, chest radiograph and high-resolution computed tomography. Patients were diagnosed and classified according to the Rosenberg-Patterson criteria for ABPA. The cut-off value for total serum IgE was calculated by receiver operating characteristics curve analysis.
  
  
  RESULTS
  Of 100 children with poorly controlled asthma, 26 patients were ABPA positive. There was a significant difference in the forced expiratory volume in 1-sec/forced vital capacity ratio between ABPA positive (0.78 ± 0.14) and negative (0.87 ± 0.15) children (p = 0.008). ABPA positive children were categorised as seropositive, central bronchiectasis and other radiological findings. The receiver operating characteristics curve was constructed, and a value of 1200 IU/mL of total IgE was observed, with 88.5% sensitivity and 70.5% specificity.
  
  
  CONCLUSIONS
  This study showed an association between ABPA and poorly controlled asthma in children and suggests a higher cut-off value of total IgE for the diagnosis of ABPA.
authors.affiliation: Advanced Pediatric Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Meenu
authors.initials: M
authors.lastname: Singh
authors.forename: Subhamoy
authors.initials: S
authors.lastname: Das
authors.forename: Anil
authors.initials: A
authors.lastname: Chauhan
authors.forename: Nandini
authors.initials: N
authors.lastname: Paul
authors.forename: Kushaljit Singh
authors.initials: KS
authors.lastname: Sodhi
authors.forename: Joseph
authors.initials: J
authors.lastname: Mathew
authors.forename: Arunaloke
authors.initials: A
authors.lastname: Chakrabarti
mesh_terms: D000293:Adolescent; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D001232:Aspergillus fumigatus / Q000276:immunology*; D001249:Asthma / Q000097:blood / Q000150:complications / Q000276:immunology / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood* / Q000276:immunology; D008297:Male; D012129:Respiratory Function Tests
chemical_list: D007073:Immunoglobulin E
keywords: Airway inflammation; Allergy; Asthma