Aspergillosis IgG antibodies

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Useful for diagnosing Chronic Pulmonary Aspergillosis (CPA) and Allergic Bronchopulmonary Aspergillosis (ABPA)

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Aspergillosis IgG Antibodies - Comprehensive Medical Test Guide

Why is it done?
- This test measures IgG antibodies against Aspergillus species, which are fungal organisms that cause aspergillosis infections in humans.
- Primary indications include: diagnosis of chronic pulmonary aspergillosis (CPA), allergic bronchopulmonary aspergillosis (ABPA), aspergilloma detection, and invasive aspergillosis in immunocompromised patients.
- Screening patients with persistent respiratory symptoms, chronic cough, hemoptysis, or fever of unknown origin, particularly in those with risk factors such as immunosuppression, cystic fibrosis, or previous tuberculosis.
- Monitoring response to antifungal therapy and assessing disease progression in confirmed aspergillosis cases.
- Typically performed when clinical suspicion exists for aspergillosis or when imaging studies reveal suspicious pulmonary findings.
Normal Range
- Normal Result: Negative or Non-Reactive • Values: < 0.8 Index or < 10% positivity, depending on the assay method used • Interpretation: Absence of IgG antibodies to Aspergillus species indicates no current or prior aspergillosis infection.
- Borderline/Equivocal Result: 0.8-1.2 Index or 10-15% positivity • Requires clinical correlation and possible repeat testing • May suggest early infection or low antibody levels
- Positive Result: > 1.2 Index or > 15% positivity • Indicates presence of IgG antibodies against Aspergillus • Suggestive of current or previous aspergillosis infection • Higher titers may indicate chronic or active disease
- Units of Measurement: Index values (0-4+), percentages, or specific antibody titers depending on laboratory methodology (ELISA, immunofluorescence, or immunodiffusion).
Interpretation
- Positive IgG antibodies indicate immune response to Aspergillus exposure. Since IgG represents the late immune response, positive results suggest chronic or past infection rather than acute disease.
- Chronic Pulmonary Aspergillosis (CPA): Positive IgG is highly significant, especially when combined with characteristic radiological findings (cavitary lung lesions, nodules, or infiltrates) and clinical symptoms.
- Allergic Bronchopulmonary Aspergillosis (ABPA): High or rising IgG titers combined with elevated IgE, eosinophilia, and pulmonary infiltrates support diagnosis. Serial titers useful for monitoring disease activity.
- Aspergilloma: Persistent positive IgG indicates colonization of pre-existing cavitary lung disease with Aspergillus. Often accompanied by IgM antibodies in acute colonization.
- Negative result does not completely exclude aspergillosis, particularly in early invasive disease in severely immunocompromised patients who may not mount adequate antibody response.
- Factors affecting results: Immunosuppression (may reduce antibody production), timing of testing in disease course, specific Aspergillus species involved, and cross-reactivity with other fungal species.
- Clinical significance increases when combined with positive IgM (indicating acute infection), galactomannan antigen detection, or PCR for Aspergillus DNA.
Associated Organs
- Primary organ system: Respiratory system (lungs and airways). Aspergillus primarily causes infection through inhalation of spores.
- Secondary organs potentially affected: Sinuses, bronchi, pleura, and in disseminated disease, brain, heart, kidneys, and skin.
- Medical conditions associated with abnormal results: • Chronic Pulmonary Aspergillosis (CPA) • Allergic Bronchopulmonary Aspergillosis (ABPA) • Aspergilloma (fungal ball) • Acute Invasive Aspergillosis (particularly in immunocompromised hosts) • Chronic Granulomatous Disease with Aspergillus infection
- Potential complications of aspergillosis: • Massive hemoptysis • Progressive pulmonary fibrosis • Chronic respiratory failure • Disseminated infection in immunocompromised patients • Death if untreated in invasive aspergillosis
- Risk populations: Patients with HIV/AIDS, hematologic malignancies, post-transplantation, long-term corticosteroid use, cystic fibrosis, chronic obstructive pulmonary disease (COPD), asthma, and previous pulmonary tuberculosis.
Follow-up Tests
- If positive IgG detected: • Aspergillus IgM antibodies - to assess for acute infection • Galactomannan antigen - to evaluate for active disease • Aspergillus DNA (PCR) - for direct pathogen detection • High-resolution CT chest - to evaluate for characteristic radiological findings
- For suspected ABPA: • Total IgE levels - often markedly elevated • Aspergillus-specific IgE • Eosinophil count - typically elevated • Pulmonary function tests • Chest imaging
- Confirmatory tests: • Sputum culture for Aspergillus species • Bronchoalveolar lavage (BAL) with culture and PCR • Lung tissue biopsy if diagnosis remains unclear
- Immunological assessment: • CD4 count in HIV-positive patients • Immune function evaluation in immunocompromised hosts
- Monitoring frequency: • Initial testing: Every 2-4 weeks during active treatment • Maintenance phase: Every 3-6 months for chronic disease • Repeat IgG testing: 3-6 months after initiation of antifungal therapy to assess response
- Additional complementary tests: • Beta-D-glucan (non-specific fungal marker) • Serum LDH (elevated in invasive disease) • Blood cultures if invasive aspergillosis suspected
Fasting Required?
- No fasting required. This is a serology test that does not require fasting prior to blood collection.
- Patient can eat and drink normally before the test.
- No medications need to be withheld specifically for this test.
- Standard blood draw preparation: • Wear comfortable, loose-fitting clothing to facilitate vein access • Inform phlebotomist of any bleeding disorders or current anticoagulation therapy • Remain calm and hydrated before blood collection
- Timing considerations: Results are more reliable when blood is drawn in the afternoon if possible, as antibody levels can show diurnal variation.
- No special preparation required beyond standard blood draw precautions.

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