title: Role of Aspergillus fumigatus-specific IgG in diagnosis and monitoring treatment response in allergic bronchopulmonary aspergillosis.
abstract: Few studies have evaluated the utility of Aspergillus fumigatus-specific IgG in allergic bronchopulmonary aspergillosis (ABPA). Herein, we evaluate the role of specific IgG in diagnosis and monitoring treatment response in ABPA. Forty-eight control subjects with A. fumigatus-associated asthma underwent A. fumigatus-specific IgG measurements at baseline, while specific IgG was assayed in 102 treatment-naïve subjects of ABPA at baseline, after eight weeks of glucocorticoid therapy, and during exacerbations. For determining the cut-off of A. fumigatus-specific IgG, we randomly classified two-thirds of the study subjects (cases and controls) as the derivation cohort, while the remaining one-thirds were labelled as the validation cohort. The best cut-off value of A. fumigatus-specific IgG in the derivation cohort was 26.9 mgA/L (sensitivity: 88%; specificity: 100%). Using this limit, the sensitivity and specificity of A. fumigatus-specific IgG in diagnosis of ABPA was 89% and 100%, respectively, in the validation cohort. In contrast, the sensitivity of Aspergillus precipitins was only 27.4%. Following treatment, the A. fumigatus-specific IgG increased in 38 (37.2%) subjects, while it decreased in three (23.1%) of the 13 subjects experiencing an exacerbation. The A. fumigatus-specific IgG was found to be an extremely useful test in the diagnosis and differential diagnosis of ABPA but is unreliable in monitoring treatment response in this disorder.
authors: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors: Ritesh
authors: R
authors: Agarwal
authors: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors: Devika
authors: D
authors: Dua
authors: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors: Hansraj
authors: H
authors: Choudhary
authors: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors: Ashutosh N
authors: AN
authors: Aggarwal
authors: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors: Inderpaul S
authors: IS
authors: Sehgal
authors: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors: Sahajal
authors: S
authors: Dhooria
authors: Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors: Mandeep
authors: M
authors: Garg
authors: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors: Digambar
authors: D
authors: Behera
authors: Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors: Arunaloke
authors: A
authors: Chakrabarti
mesh_terms: D000328:Adult; D000908:Antibodies, Fungal / Q000097:blood* / Q000276:immunology; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D001232:Aspergillus fumigatus / Q000276:immunology*; D001249:Asthma / Q000175:diagnosis / Q000382:microbiology; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D005260:Female; D005453:Fluorescence; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood* / Q000276:immunology; D008297:Male; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D000908:Antibodies, Fungal; D005938:Glucocorticoids; D007074:Immunoglobulin G; D007073:Immunoglobulin E
keywords: abpm; allergic bronchopulmonary aspergillosis; allergic bronchopulmonary mycosis; allergy; aspergillus; asthma