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ABPA Profile - Allergic Bronchopulmonary Aspergillosis
Bacterial/ Viral
3 parameters
Report in 48Hrs
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No Fasting Required
Details
Blood test panel (IgE, IgG, eosinophils) for ABPA diagnosis.
₹4,799₹7,643
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Parameters
- List of Tests
- Aspergillius fumigatus (Fungus)
- Aspergillius fumigtus - IgG
- Total IgE
ABPA Profile - Allergic Bronchopulmonary Aspergillosis
- Why is it done?
- The ABPA Profile is used to diagnose and assess Allergic Bronchopulmonary Aspergillosis, a complex hypersensitivity response to Aspergillus fumigatus colonization in the lungs
- Indicated for patients with persistent asthma, recurrent pulmonary infiltrates, or chronic cough that is unresponsive to standard treatment regimens
- Essential for screening high-risk patients including those with cystic fibrosis, severe asthma, or other chronic airway diseases complicated by fungal colonization
- The three individual tests work together synergistically: Aspergillus fumigatus (Fungus) identifies the organism, Aspergillus fumigatus-IgG demonstrates sensitization and chronic colonization, and Total IgE reflects the degree of allergic/hypersensitivity response
- Used to monitor disease progression and treatment response in patients with confirmed or suspected ABPA
- Can differentiate ABPA from simple aspergillus colonization or aspergillomas based on immunological response pattern
- Normal Range
- Aspergillus fumigatus (Fungus): Negative or <0.35 kU/L (or <0.35 Interim Reference Units) - Absence of detectable antigen-specific IgE indicates no sensitization or minimal exposure to Aspergillus fumigatus
- Aspergillus fumigatus-IgG: Negative or <0.9 mg/L - Absence of IgG antibodies indicates no significant past or ongoing sensitization and colonization by Aspergillus fumigatus
- Total IgE: <100-150 IU/mL (International Units per milliliter) - Normal range varies by laboratory and age, with most adults having total IgE below 100 IU/mL; levels up to 150 IU/mL may be considered borderline in some laboratories
- Borderline or Equivocal ranges: Aspergillus fumigatus IgE 0.35-0.7 kU/L may suggest possible sensitization requiring clinical correlation; Aspergillus fumigatus-IgG between 0.9-1.5 mg/L indicates possible mild sensitization
- Positive/Abnormal interpretation: Aspergillus fumigatus IgE >0.7 kU/L indicates sensitization; Aspergillus fumigatus-IgG >1.5 mg/L indicates significant exposure and immune response; Total IgE >1000 IU/mL is highly suggestive of ABPA when accompanied by elevated Aspergillus-specific antibodies
- Interpretation
- Aspergillus fumigatus (Fungus) IgE Interpretation: Negative result (<0.35 kU/L) essentially excludes ABPA with high probability; Weakly positive (0.35-0.7 kU/L) suggests possible sensitization and warrants clinical evaluation; Strongly positive (>0.7 kU/L) indicates definite sensitization to Aspergillus fumigatus and significant risk for ABPA development
- Aspergillus fumigatus-IgG Interpretation: Negative (<0.9 mg/L) suggests no established colonization or immune sensitization; Weakly positive (0.9-1.5 mg/L) may indicate recent or mild exposure; Moderately positive (1.5-3.0 mg/L) indicates ongoing sensitization and colonization; Strongly positive (>3.0 mg/L) suggests chronic colonization with significant immune response and higher likelihood of active ABPA
- Total IgE Interpretation: <100 IU/mL is normal; 100-500 IU/mL suggests mild to moderate allergic response; 500-1000 IU/mL indicates significant allergic/immune activation; >1000 IU/mL is highly concerning for ABPA when combined with positive Aspergillus-specific antibodies; >2000 IU/mL is strongly suggestive of acute ABPA exacerbation
- Combined Profile Interpretation: All three tests negative essentially excludes ABPA diagnosis; Positive Aspergillus fumigatus IgE with negative IgG suggests recent sensitization without colonization; Positive IgG with variable IgE indicates chronic colonization; Both IgE and IgG positive with elevated total IgE (>1000 IU/mL) strongly supports ABPA diagnosis when correlated with clinical and radiological findings
- Serial monitoring interpretation: Rising Total IgE in context of positive Aspergillus antibodies suggests disease exacerbation requiring treatment intensification; Stable or declining Total IgE indicates treatment response; Persistent positive IgG with negative or declining IgE may indicate controlled/stable colonization
- Factors affecting results: Recent immunosuppressive therapy may falsely lower results; Allergic conditions unrelated to Aspergillus can elevate Total IgE; Immunodeficiency disorders may impair antibody production; Cross-reactivity with other fungal species can rarely cause false positives; Results require clinical correlation with symptoms, imaging findings, and pulmonary function tests
- Associated Organs
- Lungs: Primary organ affected by ABPA - abnormal results indicate inflammation, colonization, and bronchial damage; Aspergillus fumigatus IgE and IgG reflect respiratory sensitization; Elevated Total IgE correlates with severity of pulmonary allergic inflammation
- Bronchial Airways: Abnormal results indicate allergic airway inflammation, bronchial plugging with fungal material, and risk of bronchiectasis development; Chronic disease can lead to permanent airway remodeling and bronchial wall thickening
- Immune System: All three tests evaluate immune system function - Aspergillus-specific antibodies (IgE and IgG) indicate active immune sensitization; Elevated Total IgE reflects overall allergic immune dysregulation; Abnormal results suggest Type I and Type III hypersensitivity reactions
- Aspergillus fumigatus (Fungus) detects: Fungal colonization in respiratory tract, sensitization status to specific fungal antigen, risk for hypersensitivity pneumonitis and mycotic lung disease progression
- Aspergillus fumigatus-IgG detects: Chronic or recurrent exposure to fungal antigen, establishment of ongoing colonization, immune response to fungal antigens indicating past or present infection, risk of progressive lung damage
- Total IgE evaluates: Overall allergic state and hypersensitivity status, degree of immune activation in response to fungal and other allergens, severity of allergic inflammation, effectiveness of immunosuppressive and anti-inflammatory therapy
- Potential complications of abnormal results: Bronchiectasis development, progressive pulmonary fibrosis, chronic obstructive pulmonary disease (COPD), pulmonary hypertension, respiratory failure, fungal dissemination in immunocompromised patients
- Follow-up Tests
- If Aspergillus fumigatus IgE is abnormal: High-resolution CT (HRCT) chest imaging to evaluate for characteristic ABPA findings including central bronchiectasis, bronchial wall thickening, pulmonary infiltrates, and mucoid impaction
- If Aspergillus fumigatus-IgG is abnormal: Aspergillus-specific IgA testing to further characterize immune response and chronic colonization; Sputum culture and fungal staining to attempt isolation and identification of organisms
- If Total IgE is significantly elevated: Pulmonary function tests (PFTs) including FEV1, FVC, and FEF25-75 to assess degree of airway obstruction; Diffusing capacity (DLCO) to evaluate for parenchymal involvement and fibrosis
- Complementary diagnostic tests for ABPA confirmation: Eosinophil count (elevated >500/μL suggests active ABPA); Skin prick testing with Aspergillus antigen; Aspergillus-specific IgE by ImmunoCAP or similar quantitative methods
- Monitoring frequency for diagnosed ABPA: Baseline tests at diagnosis, then repeat Total IgE and Aspergillus-specific antibodies every 3-6 months during active disease, annually if stable, and before/after treatment changes
- Additional investigations if ABPA confirmed: Serum creatinine and liver function tests to establish baseline before antifungal therapy; Baseline audiometry before antifungal treatment as some agents are ototoxic
- Disease staging and prognosis follow-up: Chest X-ray to assess progression of infiltrates; 6-minute walk test to evaluate functional status; Repeat imaging every 6-12 months depending on disease stage to monitor bronchiectasis development
- Fasting Required?
- Fasting Required: No - The ABPA Profile does not require fasting as it is based on serological testing of blood antibodies and antigens, which are not affected by dietary intake
- Patients may eat and drink normally before blood collection for all three component tests (Aspergillus fumigatus IgE, Aspergillus fumigatus-IgG, and Total IgE)
- Medications: Most medications do not need to be discontinued before testing; however, antihistamines (such as diphenhydramine, cetirizine, loratadine) should be avoided 48-72 hours before blood draw if skin prick testing is planned as a confirmatory test, though they do not affect serum antibody testing
- Immunosuppressive medications: Systemic corticosteroids or other immunosuppressants may reduce antibody levels; continue taking as prescribed but inform the laboratory and physician of all medications to aid in result interpretation
- Patient preparation: No special preparation needed beyond routine blood draw procedures; arrive with clean arm; avoid scratching or applying lotion to the venipuncture site on the day of testing
- Timing considerations: Optimal timing for testing is typically during acute exacerbations for maximum sensitivity, though baseline testing during stable disease is also valuable; serial testing can be performed at any time without regard to meals
- Recent respiratory infections: If possible, wait 2-4 weeks after acute respiratory infection before testing to avoid transient elevation of Total IgE unrelated to ABPA; however, if clinical suspicion is high, testing can proceed with notation of recent infection for result interpretation
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