New clinical diagnostic criteria for allergic bronchopulmonary aspergillosis/mycosis and its validation

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:147

Article

Asano, Koichiro¹  Hebisawa, Akira³  Ishiguro, Takashi⁷  Takayanagi, Noboru⁷  Nakamura, Yasuhiko³  Suzuki, Junko⁴  Okada, Naoki¹  Tanaka, Jun¹  Fukutomi, Yuma²  Ueki, Shigeharu^8,9  Fukunaga, Koichi⁵  Konno, Satoshi^10,11  Matsuse, Hiroto⁶  Kamei, Katsuhiko¹²  Taniguchi, Masami²  Shimoda, Terufumi¹³  Oguma, Tsuyoshi¹ 

[1] Tokai Univ, Dept Med, Sch Med, Div Pulm Med, 143 Shimokasuya, Isehara, Kanagawa 2591193, Japan

[2] Natl Hosp Org Sagamihara Natl Hosp, Clin Res Ctr, Yokohama, Kanagawa, Japan

[3] Natl Hosp Org Tokyo Natl Hosp, Clin Lab Ctr, Tokyo, Japan

[4] Natl Hosp Org Tokyo Natl Hosp, Dept Resp Med, Tokyo, Japan

[5] Keio Univ, Sch Med, Dept Med, Div Pulm Med, Tokyo 108, Japan

[6] Toho Univ, Ohashi Med Ctr, Dept Internal Med, Div Respirol, Tokyo, Japan

[7] Saitama Cardiovasc & Resp Ctr, Dept Resp Med, Saitama, Japan

[8] Akita Univ, Dept Gen Internal Med, Akita, Japan

[9] Akita Univ, Clin Lab Med, Akita, Japan

[10] Hokkaido Univ, Fac Med, Dept Resp Med, Sapporo, Hokkaido, Japan

[11] Hokkaido Univ, Grad Sch Med, Sapporo, Hokkaido, Japan

[12] Chiba Univ, Med Mycol Res Ctr, Div Clin Res, Chiba, Japan

[13] Natl Hosp Org Fukuoka Hosp, Clin Res Ctr, Dept Allergy, Fukuoka, Japan

关键词: Allergic bronchopulmonary aspergillosis;    allergic bronchopulmonary mycosis;    Aspergillus;    diagnosis;    eosinophils;    fungus;    IgE;    mucus plugs;    severe asthma with fungal sensitization;   

DOI  :  10.1016/j.jaci.2020.08.029

来源: Elsevier

【 摘 要 】

Background: There are several clinical diagnostic criteria for allergic bronchopulmonary aspergillosis (ABPA). However, these criteria have not been validated in detail, and no criteria for allergic bronchopulmonary mycosis (ABPM) are currently available. Objective: This study proposes new diagnostic criteria for ABPA/ABPM, consisting of 10 components, and compares its sensitivity and specificity to existing methods. Methods: Rosenberg-Patterson criteria proposed in 1977, the International Society for Human and Animal Mycology (ISHAM) criteria proposed in 2013, and this new criteria were applied to 79 cases with pathological ABPM and the control population with allergic mucin in the absence of fungal hyphae (n = 37), chronic eosinophilic pneumonia (n = 64), Aspergillus-sensitized severe asthma (n = 26), or chronic pulmonary aspergillosis (n = 24). These criteria were also applied to the 179 cases with physician-diagnosed ABPA/ABPM in a nationwide Japanese survey. Results: The sensitivity for pathological ABPM with Rosenberg-Patterson criteria, ISHAM criteria, and this new criteria were 25.3%, 77.2%, and 96.2%, respectively. The sensitivity for physician-diagnosed ABPA/ABPM were 49.2%, 82.7%, and 94.4%, respectively. The areas under the curve for the receiver-operating characteristic curves were 0.85, 0.90, and 0.98, respectively. The sensitivity for ABPM cases that were culture-positive for non-Aspergillus fungi were 13.0%, 47.8%, and 91.3%, respectively. Conclusions: The new diagnostic criteria, compared with existing criteria, showed better sensitivity and specificity for diagnosing ABPA/ABPM.

【 授权许可】

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