title: Evaluation of a Quantitative Serological Assay for Diagnosing Chronic Pulmonary Aspergillosis.
abstract: The purpose of this study was to evaluate the clinical utility of a quantitative Aspergillus IgG assay for diagnosing chronic pulmonary aspergillosis. We examined Aspergillus-specific IgG levels in patients who met the following criteria: (i) chronic (duration of >3 months) pulmonary or systemic symptoms, (ii) radiological evidence of a progressive (over months or years) pulmonary lesion with surrounding inflammation, and (iii) no major discernible immunocompromising factors. Anti-Aspergillus IgG serum levels were retrospectively analyzed according to defined classifications. Mean Aspergillus IgG levels were significantly higher in the proven group than those in the possible and control groups (P < 0.01). Receiver operating characteristic curve analysis revealed that the Aspergillus IgG cutoff value for diagnosing proven cases was 50 mg of antigen-specific antibodies/liter (area under the curve, 0.94; sensitivity, 0.98; specificity, 0.84). The sensitivity and specificity for diagnosing proven cases using this cutoff were 0.77 and 0.78, respectively. The positive rates of Aspergillus IgG in the proven and possible groups were 97.9% and 39.2%, respectively, whereas that of the control group was 6.6%. The quantitative Aspergillus IgG assay offers reliable sensitivity and specificity for diagnosing chronic pulmonary aspergillosis and may be an alternative to the conventional precipitin test.
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization, Asahikawa Medical Center, Asahikawa, Japan fujiuchi@hosp.go.jp.
authors.forename: Satoru
authors.initials: S
authors.lastname: Fujiuchi
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization, Asahikawa Medical Center, Asahikawa, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Fujita
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization, Asahikawa Medical Center, Asahikawa, Japan.
authors.forename: Hokuto
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization, Asahikawa Medical Center, Asahikawa, Japan.
authors.forename: Kazushi
authors.initials: K
authors.lastname: Doushita
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization, Asahikawa Medical Center, Asahikawa, Japan.
authors.forename: Hikaru
authors.initials: H
authors.lastname: Kuroda
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization, Asahikawa Medical Center, Asahikawa, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization, Asahikawa Medical Center, Asahikawa, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Yamazaki
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization, Asahikawa Medical Center, Asahikawa, Japan.
authors.forename: Tadakatsu
authors.initials: T
authors.lastname: Tsuji
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization, Asahikawa Medical Center, Asahikawa, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Fujikane
authors.affiliation: Cardiovascular Respiratory Frontier of Medical Renovation, Asahikawa Medical University, Asahikawa, Japan.
authors.forename: Shinobu
authors.initials: S
authors.lastname: Osanai
authors.affiliation: Respiratory Center, Asahikawa Medical University, Asahikawa, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Sasaki
authors.affiliation: Respiratory Center, Asahikawa Medical University, Asahikawa, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Ohsaki
mesh_terms: D000368:Aged; D000908:Antibodies, Fungal / Q000097:blood*; D001230:Aspergillus / Q000276:immunology*; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D055732:Pulmonary Aspergillosis / Q000175:diagnosis*; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000379:methods*
chemical_list: D000908:Antibodies, Fungal; D007074:Immunoglobulin G