SPHMMC Library

12th grade model exam at St. Paul's

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ሀገር አቀፍ የመውጫ ፈተና የሁለተኛ ቀን ፈተና በቅ/ጳ/ሆስ/ሚ/ህክምና ኮሌጅ

Practice Changing Updates Authors: April F Eichler, MD, MPH Sadhna R Vora, MD PULMONARY AND CRITICAL CARE MEDICINE (May 2024) Revised diagnostic criteria for allergic bronchopulmonary aspergillosis ●There is no individual test to establish the diagnosis of allergic bronchopulmonary aspergillosis, and the diagnosis is usually confirmed by a combination of clinical, radiographic, and immunologic findings. We favor using the 2024 revised diagnostic criteria proposed by the International Society for Human and Animal Mycology (ISHAM) that simplify prior diagnostic schema. Allergic bronchopulmonary aspergillosis (ABPA), a complex hypersensitivity reaction to airway colonization with Aspergillus fumigatus, can be hard to distinguish from difficult-to-treat asthma or cystic fibrosis. The International Society for Human and Animal Mycology (ISHAM) working group for ABPA recently published revised diagnostic criteria (table 1) that make some key changes to improve the sensitivity and specificity of the diagnosis [4]: •Total serum immunoglobulin (Ig) E levels of ≥500 international units/mL are sufficient for the diagnosis, rather than the previously higher threshold of 1000 international units/mL. •Elevated Aspergillus IgG levels by enzyme immunoassay or lateral flow assay are more sensitive for detecting sensitivity to Aspergillus antigens and should be used preferentially over Aspergillus serum precipitins. We agree with the revised ISHAM diagnostic approach. (See "Clinical manifestations and diagnosis of allergic bronchopulmonary aspergillosis", section on 'Diagnostic criteria'.)