Table V.

Staging of allergic bronchopulmonary aspergillosis (ABPA) in patients with asthma

Stage	Definition	Features
0	Asymptomatic	No previous diagnosis of ABPA
		Controlled asthma (according to Indian guidelines)
		Fulfilling the diagnostic criteria of ABPA (Table IV)
1	Acute	No previous diagnosis of ABPA
		Symptoms consistent with ABPA
		Satisfying the diagnostic criteria of ABPA
1a	With mucoid impaction	Mucoid impaction observed on thoracic imaging
1b	Without mucoid impaction	Absence of mucoid impaction on thoracic imaging
2	Response	Clinical and/or radiological improvement and decline in serum total IgE by ≥25% of baseline at 8 wk
3	Exacerbation	Clinical and/or radiological worsening and increase in serum total IgE by at least 50% from the new baseline established during response/remission
4	Remission	Sustained clinical and radiological improvement and serum total IgE levels persisting at or below baseline (or increase by <50%) for ≥6 months off treatment
5a	Treatment-dependent ABPA	Two or more exacerbations within six months of stopping therapy or clinical and/or radiological worsening, along with increase in serum total IgE levels, on tapering oral steroids/azoles
5b	Glucocorticoid- dependent asthma	Systemic glucocorticoids required for control of asthma while the ABPA activity is controlled (as indicated by serum total IgE and thoracic imaging)
6	Advanced ABPA	Extensive bronchiectasis due to ABPA on chest imaging along with either cor pulmonale and/or chronic Type II respiratory failure

Source: Reproduced with permission from Ref. 3