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Table 2 Diagnostic criteria for ABPA used for the five cases

From: Total unilateral pulmonary collapse secondary to allergic bronchopulmonary aspergillosis: a case series of an unusual cause of complete atelectasis

  Diagnostic criteria for ABPA proposed by the ISHAM working group Diagnostic criteria for ABPA/ABPM proposed by Asano et al.18
  Obligatory criteria Minor criteria  
  Elevated Aspergillus-specific IgE level
(> 0.35 kUA/L)
Elevated serum total IgE level
(> 1000 IU/mL or simply elevated if all other criteria are met)
Precipitating antibodies or IgG antibodies against Aspergillus Radiographic findings consistent with ABPA* Peripheral blood eosinophilia (≥ 500 cells/mm3) Definite ABPA: ≥ 6 criteria met
Probable ABPA: ≥ 5 criteria met
Case 1
 70 years old
Yes
(8.05 kU/L)
No
(791 kU/L)
Positive for Aspergillus fumigatus precipitins (4 precipitin bands) Total left lung collapse on X-ray No
(210/mm3)
Previous asthma-like symptoms
Elevated total serum IgE level
Specific IgE for filamentous fungi
Presence of specific IgG for filamentous fungi
Filamentous fungal growth in cultures
Presence of mucus plugs in central bronchi, based on bronchoscopy
Case 2
 74 years old
Yes
(62.6 kU/L)
Yes
(3364 kU/L)
Positive for Aspergillus-specific IgG (94 kUA/L) Total left lung collapse, central bronchiectasis and presence of mucus plugs in the central bronchi on CT Yes
(2500/mm3)
Peripheral blood eosinophilia (> 500 cells/mm3)
Elevated total serum IgE level
Immediate cutaneous hypersensitivity and specific IgE for filamentous fungi
Presence of specific IgG for filamentous fungi
Filamentous fungal growth in cultures
Presence of mucus plugs in central bronchi, based on CT/bronchoscopy
Case 3
 73 years old
Yes
(10.3 kU/L)
No
(406 kU/L)
Negative Total left lung collapse, no high-attenuation mucus plug or central bronchiectasis in the contralateral lung Yes
(800/mm3)
Current or previous asthma-like symptoms
Peripheral blood eosinophilia (> 500 cells/mm3)
Specific IgE for filamentous fungi
Presence of fungal hyphae in bronchial mucus plugs
Presence of mucus plugs in central bronchi, based on CT/bronchoscopy and mucus plug expectoration history
Case 4
 72 years old
Yes
(56.6 kU/L)
Yes
(2442 kU/L)
Positive Complete atelectasis of the left lung, tram-track opacities in the right lower field No** Elevated total serum IgE level
Specific IgE for filamentous fungi
Presence of specific IgG for filamentous fungi
Filamentous fungal growth in endoscopic cultures
Presence of mucus plugs in central bronchi, based on bronchoscopy
Case 5
 81 years old
Yes
(71.5 kUA/L)
Yes
(2464 kU/L)
Negative Right lung atelectasis on CT, no other findings consistent with ABPA Yes
(1009/mm3)
Current or previous asthma-like symptoms
Peripheral blood eosinophilia (> 500 cells/mm3)
Elevated total serum IgE level
Specific IgE for filamentous fungi
Filamentous fungal growth in cultures
Presence of mucus plugs in central bronchi, based on bronchoscopy
  1. ABPA: Allergic bronchopulmonary aspergillosis. ABPM: Allergic bronchopulmonary mycosis
  2. *Radiographic findings consistent with ABPA may be transient (i.e., consolidation, nodules, tram-track opacities, toothpaste/finger-in-glove opacities, fleeting opacities) or permanent (i.e., parallel line and ring shadows, bronchiectasis and pleuropulmonary fibrosis)
  3. **The only eosinophil count available was obtained while the patient was already treated with corticosteroids
  4. Filamentous fungus: Aspergillus fumigatus