Aspergillus ABPA Precipitins

Immunology

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Description

Aspergillus precipitins can be found in cases of allergic bronchopulmonary aspergillosis (ABPA) and extrinsic allergic alveolitis (EAA). Specific IgE to aspergillus should also be tested. ABPA occurs predominantly in patients with asthma, but is also a known complication of cystic fibrosis (CF) [1]. This chronic relapsing disorder ranges clinically from mild asthma to fatal destructive lung disease and is caused by hypersensitivity to colonized Aspergillus fumigatus [3]. The measurement of aspergillus precipitins may also be useful in the diagnosis of hypersensitivity pneumonitis [2]. The UK cystic fibrosis trust have made a list of diagnositic criteria for the diagnosis of ABPA in CF patients [1]. A positive test should not be, of itself, interpreted as representing a pathologic state. It may simply reflect a normal immune response to a prior or ongoing exposure to the antigen in question. Nor does the absence of precipitins eliminate the diagnosis since precipitins are reduced or absent when the disease is not in an acute state.

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Indications

Allergic bronchopulmonary aspergillosis (ABPA) and extrinsic allergic alveolitis (EAA).

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Sample Type

2mL Serum (Gel 5mL Yellow tube). Requests from outside Sheffield: Transport at ambient temperature via Royal Mail or Courier.

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Reference Range

< 40 mg/L.Reference range established in house.

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Turnaround Time

Within 5 days

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Testing Frequency

Daily

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External Notes

The test is not of diagnostic value in itself. Results should not be used in isolation, but interpreted in conjunction with the patient's symptoms, the patient's history and any other available data.

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References

Thia LP and Balfour Lynn IM. Diagnosing allergic bronchopulmonary aspergillosis in children withcystic fibrosis. Paed Res Rev. 2009. 10:37-42. [Ref 1]Berna P, et al. Pulmonary sequestration and aspergillosis. Eur J Cardiothorac Surg. 2005. 27(1):28-31. [Ref 2] Shah A and Chandramani P. Allergic bronchopulmonary aspergillosis: A review of a disease with a worldwide distribution. J Asthma. 2002. 39(4):273-289. [Ref 3]

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