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. 2019 Apr 27;11(4):e4550. doi: 10.7759/cureus.4550

Table 2. Diagnostic Criteria for ABPA.

ABPA: allergic bronchopulmonary aspergillosis; Af: Aspergillus fumigatus; CB: central bronchiectasis; CF: cystic fibrosis; IgE: immunoglobulin E; IgG: immunoglobulin G; ISHAM: International Society for Human and Animal Mycology.

Name Diagnostic Criteria for ABPA
1977, Rosenberg-Patterson Criteria [15, 16] Major Criteria: (1) asthma, (2) presence of fleeting or fixed pulmonary opacities on chest radiograph, (3) immediate cutaneous hypersensitivity reaction to Af, (4) total serum IgE elevated, more than 1000 IU/mL, (5) precipitating antibodies against Af, (6) peripheral blood eosinophilia, (7) central or proximal bronchiectasis with normal tapering of distal bronchi
Minor Criteria: (1) golden brown sputum plugs in expectorant, (2) positive sputum culture for aspergillus species, (3) late (arthus-type) skin reactivity to Af
1999, ABPA in CF [19] Presence of two out of following three: (1) immediate cutaneous hypersensitivity reaction to Af, (2) presence of precipitating antibodies to Af, (3) elevated total IgE levels more than 1000 IU/mL
Plus at least two of following six: (1) bronchoconstriction, (2) eosinophil count more than 1000/μL, (3) history of pulmonary opacities on chest radiograph, (4) elevated IgE or IgG antibodies to Af, (5) Af in sputum smear or sputum culture, (6) response to steroids
2002, Minimum Essential Criteria [20] Criteria: (1) asthma, (2) immediate cutaneous hypersensitivity reaction to Af, (3) total serum IgE elevated more than 1000 ng/mL (417 kU/L), (4) elevated IgE and IgG antibodies to Af, (5) CB in absence of distal bronchiectasis
2012, Minimum Criteria and Additional Criteria [4] Minimum Criteria: (1) patients with asthma or cystic fibrosis, (2) worsening lung function, (3) positive skin prick test with aspergillus species, (4) total serum IgE greater than 1000 ng/mL (416 IU/mL), (5) increased aspergillus species-specific IgE and IgG antibodies, (6) infiltrates noted on chest radiography
Additional Criteria: (1) increase in serum eosinophilia when the patient is not on corticosteroids ( more than 400 eosinophils/μL), (2) aspergillus species-specific precipitating antibodies, (3) central bronchiectasis, (4) aspergillus species-specific containing mucus plugs
2013, Truly Minimal Criteria [21] Criteria: (1) asthma, (2) immediate cutaneous hypersensitivity reaction to Af, (3) total serum IgE elevated more than 1000 ng/mL (417 kU/L), (4) CB in absence of distal bronchiectasis
2013, ISHAM Working Group [22] Predisposing Conditions: (1) asthma, (2) CF
Obligatory Criteria (both need to be present): (1) type I aspergillus skin test positive (immediate cutaneous hypersensitivity reaction to Af) or elevated IgE levels against Af, (2) elevated total IgE levels more than 1000 IU/mL (unless all other criteria is met, then total IgE levels can be less than 1000 IU/mL)
Other Criteria (two out of three at least): (1) presence of IgG antibodies against Af or precipitating antibodies, (2) presence of fleeting or fixed pulmonary opacities on chest radiograph consist with ABPA, (3) eosinophil count more than 500 cells/μL in steroid naïve patient (may be a historical value)