Diagnosis of Allergic Bronchopulmonary Aspergillosis: A Case-Based Approach

Sahajal Dhooria; Ritesh Agarwal

Disclosures

Future Microbiol. 2014;9(10):1195-1208. 

In This Article

Conclusion & Future Perspective

In summary, the article provides the current evidence-based approach towards a diagnosis of ABPA. Asthmatic patients presenting to special asthma or chest clinics should be routinely screened for ABPA, with A.fumigatus specific IgE levels. It is imperative that the diagnosis of ABPA is secured as early as possible, as untreated disease usually culminates in bronchiectasis and pulmonary fibrosis, all manifestations of end-stage lung disease. More than six decades have elapsed since the original description of this disorder, however the diagnosis of ABPA still remains elusive. There is an urgent need for defining the cutoff values of various investigations such as IgE levels (total and A.fumigatus specific). Recombinant Aspergillus antigens, TARC and the FACS basophil CD203c assay seem promising tools in the diagnosis and possibly followup of ABPA, and need to be investigated preferably in a multicentric approach. There is also a dire need to study the natural history of patients with asthma and fungal sensitization so as to properly define the temporal change in various parameters (such as skin test, IgE levels and others) in these patients.

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