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Allergic Bronchopulmonary Aspergillosis

ABPA, Aspergillus fumigatus

Test Codes

EPIC: LAB6511, Beaker: XABPA, ARUP: 2004243

Department

Send Outs

Instructions

This panel includes:

• Aspergillus fumigatus #1 precipitin.
• Aspergillus fumigatus #6 precipitin.
• IgE to Af Index.
• Total IgE.

Specimen Collection Criteria

Collect (preferred specimen): 1 full Gold-top SST tube.
Also acceptable: 1 full plain Red-top tube.

Physician Office/Draw Specimen Preparation

Let specimen clot 30-60 minutes then centrifuge to separate serum from cells. Transfer serum to a plastic transport tube and refrigerate (2-8°C or 36-46°F).

Preparation for Courier Transport

Transport: 2.5 mL serum, refrigerated (2-8°C or 36-46°F). (Minimum: 0.5 mL)

Rejection Criteria

• Plasma specimens.
• Hemolyzed specimen
• Icteric specimen
• Lipemic specimen
• Specimens not collected and processed as indicated.

In-Lab Processing

Let specimen clot 30-60 minutes then centrifuge to separate serum from cells. Transfer serum to a plastic transport tube and refrigerate (2-8°C or 36-46°F).

Transport: 2.5 mL serum, refrigerated (2-8°C or 36-46°F). (Minimum: 0.5 mL)

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 48 hours
Refrigerated (2-8°C or 36-46°F): 14 days
Frozen (-20°C/-4°F or below): 365 days

Specimen Storage in Department Prior to Disposal:

Specimen retention time is determined by the policy of the reference laboratory. Contact the Send Outs Laboratory with any questions.

Laboratory

Sent to ARUP in Salt Lake City, UT.

Performed

Sunday – Saturday
Results available within 3-7 days. 

Reference Range

By report.

Test Methodology

Quantitative ImmunoCAP Fluorescent Enzyme Immunoassay/Qualitative Immunodiffusion

Clinical Utility

Allergic Bronchopulmonary Aspergillosis is a complication in about 1-2% of patients with persistent asthma and up to 15% of patients with cystic fibrosis. In its classic form, the following criteria are present:

• Asthma (mild to severe).
• Central bronchiectasis (bronchial wall widening) in the inner 2/3 of the lung fields.
• Positive immediate skin reaction to Aspergillus fumigatus.
• Elevated total serum IgE concentration.
• Precipitating IgE antibodies to Aspergillus fumigatus.
• History of chest radiograph or computerized tomography infiltrates not explained by other causes.
• Peripheral blood eosinophilia.

Central bronchiectasis in a patient with asthma is virtually diagnostic for the condition. Mandel's Principles and Practice of Infectious Diseases suggests that the first 5 of the above are the minimal essential criteria with the presence of precipitating antibodies to Aspergillus further supporting the diagnosis. Total IgE levels correlate with disease exacerbations. In cystic fibrosis (CF) patients, the diagnosis can be particularly difficult because many of the diagnostic criteria overlap with the common manifestations of CF. Some patients may expectorate sputum plugs that contain the fungus, Aspergillus fumigatus. Patients typically are allergic in the sense that they not only have hay fever (allergic rhinitis) and allergic asthma, but they also have some drug allergies, food allergies or current or previous atopic dermatitis (eczema).

CPT Codes

82785, 86003, 86606x2.

Contacts

Last Updated

10/16/2023