Takashi Ishiguro1, Noboru Takayanagi2, Ryuji Uozumi3, Yuri Baba4, Eriko Kawate5, Yoichi Kobayashi6, Yotaro Takaku7, Naho Kagiyama8, Yoshihiko Shimizu9, Satoshi Morita10, Yutaka Sugita11. 1. Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya City, Saitama Pref. 360-0105, Japan. Electronic address: ishiguro.takashi@pref.saitama.lg.jp. 2. Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya City, Saitama Pref. 360-0105, Japan. Electronic address: takayanagi.noboru@pref.saitama.lg.jp. 3. Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan. Electronic address: uozumi@kuhp.kyoto-u.ac.jp. 4. Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya City, Saitama Pref. 360-0105, Japan. Electronic address: koyuringo42@gmail.com. 5. Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya City, Saitama Pref. 360-0105, Japan. Electronic address: kawate.eriko.am@pref.saitama.lg.jp. 6. Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya City, Saitama Pref. 360-0105, Japan. Electronic address: m00039yk@jichi.ac.jp. 7. Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya City, Saitama Pref. 360-0105, Japan. Electronic address: takaku.yotaro@pref.saitama.lg.jp. 8. Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya City, Saitama Pref. 360-0105, Japan. Electronic address: kagiyama.naho@pref.saitama.lg.jp. 9. Department of Pathology, Saitama Cardiovascular and Respiratory Center, Saitama, Japan. Electronic address: shimizu.yoshihiko@pref.saitama.lg.jp. 10. Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan. Electronic address: smorita@kuhp.kyoto-u.ac.jp. 11. Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya City, Saitama Pref. 360-0105, Japan. Electronic address: sugita.yutaka.am@pref.saitama.lg.jp.
Abstract
BACKGROUND: Several diagnostic criteria have been proposed to differentiate allergic bronchopulmonary mycosis (ABPM) from asthma, but there have been no studies to establish diagnostic criteria to classify ABPM differently from other eosinophilic lung diseases. METHODS: We retrospectively investigated both patients with ABPM (n=42) diagnosed by clinical (Rosenberg-Patterson criteria modified to apply to fungi other than Aspergillus spp., with consideration of computed tomography and bronchoscopy findings) or pathological criteria and those with other eosinophilic lung diseases (n=118) to establish elaborate diagnostic criteria for ABPM. RESULTS: Etiologies of ABPM included fungi other than Aspergillus spp. or unidentified pathogens in 16 patients. Fourteen patients (33.3%) did not have asthma. When the diagnostic cutoff line was set to satisfy six or more primary plus secondary modified Rosenberg-Patterson criteria, ABPM could be diagnosed with good sensitivity, specificity, and positive/negative predictive values (97.6%, 98.3%, 95.3%, and 99.1%, respectively). When the diagnostic criteria were combined with pathological criteria, the values further improved to 100%, 98.3%, 95.5%, and 100%, respectively. CONCLUSIONS: Our results suggest that these novel criteria offer good sensitivity, specificity, and positive/negative predictive values for the diagnosis and classification of ABPM.
BACKGROUND: Several diagnostic criteria have been proposed to differentiate allergic bronchopulmonary mycosis (ABPM) from asthma, but there have been no studies to establish diagnostic criteria to classify ABPM differently from other eosinophilic lung diseases. METHODS: We retrospectively investigated both patients with ABPM (n=42) diagnosed by clinical (Rosenberg-Patterson criteria modified to apply to fungi other than Aspergillus spp., with consideration of computed tomography and bronchoscopy findings) or pathological criteria and those with other eosinophilic lung diseases (n=118) to establish elaborate diagnostic criteria for ABPM. RESULTS: Etiologies of ABPM included fungi other than Aspergillus spp. or unidentified pathogens in 16 patients. Fourteen patients (33.3%) did not have asthma. When the diagnostic cutoff line was set to satisfy six or more primary plus secondary modified Rosenberg-Patterson criteria, ABPM could be diagnosed with good sensitivity, specificity, and positive/negative predictive values (97.6%, 98.3%, 95.3%, and 99.1%, respectively). When the diagnostic criteria were combined with pathological criteria, the values further improved to 100%, 98.3%, 95.5%, and 100%, respectively. CONCLUSIONS: Our results suggest that these novel criteria offer good sensitivity, specificity, and positive/negative predictive values for the diagnosis and classification of ABPM.
Authors: Aleksandra Barac; David S Y Ong; Ljiljana Jovancevic; Aleksandar Peric; Pavol Surda; Vesna Tomic Spiric; Salvatore Rubino Journal: Front Microbiol Date: 2018-04-03 Impact factor: 5.640