Agarwal et al reported criteria for the diagnosis of allergic bronchopulmonary aspergillosis (ABPA). The authors are from the ABPA complicating asthma ISHAM working group.
Predisposing conditions:
(1) bronchial asthma
(2) cystic fibrosis
Obligatory criteria - both of the following (ideally):
(1) one or both of the following:
(1a) immediate hypersensitivity to Aspergillus antigen (Type I Aspergillus skin test positive)
(1b) elevated serum IgE levels against Aspergillus fumigatus
(2) serum total IgE level > 1,000 IU/mL (may be waived if all other findings present)
Other criteria (>= 2 of the following):
(1) precipitating or IgG serum antibodies against Aspergillus fumigatus
(2) chest imaging studies consistent with allergic bronchopulmonary aspergillosis
(3) absolute eosinophil count > 500 per microliter in a steroid-naive patient (may be historical)
Chest imaging findings consistent with ABPA - may be transient or permanent:
(1) consolidation
(2) nodules
(3) tram-track opacities
(4) toothpaste (finger-in-glove) opacities
(5) fleeting opacities
(6) parallel line and ring shadows
(7) bronchiectasis
(8) pleuropulmonary fibrosis
