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- Title
Role of Aspergillus fumigatus-specific IgG in diagnosis and monitoring treatment response in allergic bronchopulmonary aspergillosis.
- Authors
Agarwal, Ritesh; Dua, Devika; Choudhary, Hansraj; Aggarwal, Ashutosh N.; Sehgal, Inderpaul S.; Dhooria, Sahajal; Garg, Mandeep; Behera, Digambar; Chakrabarti, Arunaloke
- 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.
- Subjects
IMMUNOGLOBULIN G; PULMONARY aspergillosis; ASPERGILLUS fumigatus; DIFFERENTIAL diagnosis; THERAPEUTIC use of glucocorticoids; DISEASE exacerbation; DIAGNOSIS; THERAPEUTICS
- Publication
Mycoses, 2017, Vol 60, Issue 1, p33
- ISSN
0933-7407
- Publication type
Article
- DOI
10.1111/myc.12541