Diagnostic criteria that can most accurately differentiate allergic bronchopulmonary mycosis from other eosinophilic lung diseases: A retrospective, single-center study

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• 作者：Takashi Ishiguro ; M.D. ; Ph.D.^a ; ^{ishiguro.takashi@pref.saitama.lg.jp" class="auth_mail" title="E-mail the corresponding author} ; Noboru Takayanagi ; M.D. ; Ph.D.^a ; ^{takayanagi.noboru@pref.saitama.lg.jp" class="auth_mail" title="E-mail the corresponding author} ; Ryuji Uozumi ; M.S.^c ; ^{uozumi@kuhp.kyoto-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Yuri Baba ; M.D.^a ; ^{koyuringo42@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Eriko Kawate ; M.D. ; Ph.D.^a ; ^{kawate.eriko.am@pref.saitama.lg.jp" class="auth_mail" title="E-mail the corresponding author} ; Yoichi Kobayashi ; M.D.^a ; ^{m00039yk@jichi.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Yotaro Takaku ; M.D. ; Ph.D.^a ; ^{takaku.yotaro@pref.saitama.lg.jp" class="auth_mail" title="E-mail the corresponding author} ; Naho Kagiyama ; M.D. ; Ph.D.^a ; ^{kagiyama.naho@pref.saitama.lg.jp" class="auth_mail" title="E-mail the corresponding author} ; Yoshihiko Shimizu ; M.D. ; Ph.D.^b ; ^{shimizu.yoshihiko@pref.saitama.lg.jp" class="auth_mail" title="E-mail the corresponding author} ; Satoshi Morita ; Ph.D.^c ; ^{smorita@kuhp.kyoto-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Yutaka Sugita ; M.D.^a ; ^{sugita.yutaka.am@pref.saitama.lg.jp" class="auth_mail" title="E-mail the corresponding author}
• 关键词：ABPA ; allergic bronchopulmonary aspergillosis ; ABPM ; allergic bronchopulmonary mycosis ; CT ; computed tomography ; HAM ; hyperattenuating mucous ; IgE ; immunoglobulin E ; IgG ; immunoglobulin G
• 刊名：Respiratory Investigation
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：54
• 期：4
• 页码：264-271
• 全文大小：350 K

文摘

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.