PMID- 18947811
OWN - NLM
STAT- MEDLINE
DCOM- 20090415
LR  - 20220316
IS  - 0732-8893 (Print)
IS  - 0732-8893 (Linking)
VI  - 62
IP  - 3
DP  - 2008 Nov
TI  - Serologic diagnosis of allergic bronchopulmonary aspergillosis in patients with 
      cystic fibrosis through the detection of immunoglobulin G to Aspergillus 
      fumigatus.
PG  - 287-91
LID - 10.1016/j.diagmicrobio.2008.06.018 [doi]
AB  - Allergic bronchopulmonary aspergillosis (ABPA) is seen in approximately 10% of 
      patients with cystic fibrosis (CF) and can be difficult to diagnose. Consensus 
      criteria require the presence of multiple elevated immunologic markers such as 
      total immunoglobulin E (IgE), Aspergillus IgE and Aspergillus IgG, or precipitins 
      for a robust diagnosis. There is some degree of standardization of total IgE and 
      Aspergillus IgE levels, but there is no standardization in the measurement of IgG 
      antibodies or precipitins to Aspergillus. The interpretation of results may, 
      therefore, be confusing. Eighty-seven patients with CF were categorized as having 
      ABPA or as controls, using the consensus criteria and an in-house enzyme 
      immunoassay to measure IgG levels to Aspergillus. All sera from patients were 
      then analyzed by commercial fluorescent immunoassay (FEIA) for the quantitative 
      detection of anti-Aspergillus IgG. FEIA results were analyzed against the 
      consensus conference minimum diagnostic criteria to ascertain a cutoff point, 
      which could predict a diagnosis of ABPA in CF. Eighty patients with CF and with 
      no or incomplete evidence of ABPA had a mean FEIA score of 51.1 mg/L, whereas 7 
      CF patients with ABPA had a mean FEIA score of 132.5 mg/L. Using receiver 
      operator characteristic curve analysis of the ImmunoCAP (Phadia) IgG score on 
      ABPA versus all other patients gave an area under the curve of 0.933 (estimated 
      SE, 0.027). This analysis provisionally suggested that a score of 90 mg/L may be 
      used as a cutoff point, which would give a sensitivity of 91% and specificity of 
      88.0% for the diagnosis of ABPA, though this requires further validation. This 
      quantitative approach to Aspergillus IgG measurement in patients with CF along 
      with the results of other tests will hopefully provide a more accurate approach 
      to the diagnosis of ABPA.
FAU - Barton, Richard C
AU  - Barton RC
AD  - Department of Microbiology, Leeds Teaching Hospitals Trust, Leeds, UK.
FAU - Hobson, Richard P
AU  - Hobson RP
FAU - Denton, Miles
AU  - Denton M
FAU - Peckham, Daniel
AU  - Peckham D
FAU - Brownlee, Keith
AU  - Brownlee K
FAU - Conway, Steven
AU  - Conway S
FAU - Kerr, Michael A
AU  - Kerr MA
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Diagn Microbiol Infect Dis
JT  - Diagnostic microbiology and infectious disease
JID - 8305899
RN  - 0 (Antibodies, Fungal)
RN  - 0 (Immunoglobulin G)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antibodies, Fungal/*blood
MH  - Aspergillosis, Allergic Bronchopulmonary/complications/*diagnosis/immunology
MH  - Aspergillus fumigatus/*immunology
MH  - Child
MH  - Child, Preschool
MH  - Cystic Fibrosis/*complications
MH  - Humans
MH  - Immunoenzyme Techniques/methods
MH  - Immunoglobulin G/*blood
MH  - Middle Aged
MH  - ROC Curve
MH  - Sensitivity and Specificity
MH  - Young Adult
EDAT- 2008/10/25 09:00
MHDA- 2009/04/16 09:00
CRDT- 2008/10/25 09:00
PHST- 2007/12/20 00:00 [received]
PHST- 2008/05/28 00:00 [revised]
PHST- 2008/06/01 00:00 [accepted]
PHST- 2008/10/25 09:00 [pubmed]
PHST- 2009/04/16 09:00 [medline]
PHST- 2008/10/25 09:00 [entrez]
AID - S0732-8893(08)00307-6 [pii]
AID - 10.1016/j.diagmicrobio.2008.06.018 [doi]
PST - ppublish
SO  - Diagn Microbiol Infect Dis. 2008 Nov;62(3):287-91. doi: 
      10.1016/j.diagmicrobio.2008.06.018.