Diagnostic features of allergic bronchopulmonary aspergillosis (ABPA) include all of the following except:
Correct Answer: Occurrence in patients with old cavitatory lesions.
Description: Answer is D (Occurrence in patients with old cavitatory lesions): Definitive major and minor diagnostic criteria have been. defined for diagnosis of Allergic bronchopuhnonary aspergillosis. Occurance in patients with old cavitatory lesion is not a pa of either of these. Allergic bronchopulmonary aspergillosis is a pulmonary hypersensitivity disorder caused by allergy to fungal antigens that colonize the tracheobronchial tree. It most commonly occurs in atopic asthmatic individuals in response to antigen of aspergillus species. Main diagnostic criteria Clinical history of Asthma Q Pulmonary infiltrates (transient /fleeting or fixed)Q Peripheral eosinophilia (> 1000 /,uL)Q Immediate skin reactivity to Aspergillus antigen (wheal and flare response) Serum precipitins to A. fumigatus Elevated serum IgE levelsQ(>100Ong/ml) Central /proximal bronchiectasisQ Secondary diagnostic criteria History of brownish plugs in sputum Indentification / culture of A., fumigatus from sputum Late skin reactivity to aspergillus antigen - CMDT Elevated IgE (and IgG) class antibodies specific for A. fumigatus - Harrisons Note Elevated IgE (and IgG) class antibodies specific for A. fumigatus has been mentioned as a secondary diagnostic criteria in Harrison's textbook while Fishman's textbook includes this as a main/major diagnostic criteria.
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