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Specific IgE levels as an important diagnostic marker for the diagnosis of children with allergic bronchopulmonary aspergillosis

      Background

      Specific IgE against Aspergillus fumigatus has been used as a specific marker for the diagnosis of ABPA with cutoff value of >0.35KUA/L. The cut off value of specific IgE could vary with ethnicity, age, and geographic distribution. The present study determines the cutoff values of specific IgE and total IgE in north Indian children with ABPA.

      Methods

      The present study was conducted in Advanced Pediatrics Centre, PGIMER, Chandigarh with sample size of 140 children (poorly controlled asthma = 70, ABPA = 70. Children within age group of 5-15 years were included in this study after taking written informed consent/assent from families/patients. ABPA was diagnosed according to Rosenberg and Patterson criteria. Peripheral blood sample was collected to quantify total and specific IgE levels, absolute eosinophil count.

      Results

      There was a significant difference in the total IgE levels between the two groups (1995.03±1884.56 vs 5114.15±4339.38; p<0.0001). Specific IgE levels were significantly higher in the ABPA group compared to the poorly controlled asthma children (17±20vs 0.15±0.19, p< 0.0001). Receiver Operating Curve ROC was constructed to determine cut off values of specific IgE and Total IgE in the diagnosis of Children with ABPA. The ROC analysis of specific IgE levels of children with ABPA determined cut off value of 0.49KAU/L with sensitivity of 88.89% (95%CI 75.94 to 96.29%) and specificity of 94.03% (95%CI 85.41 to 98.35)and Likelihood Ratio of 14.89%.

      Conclusion

      The present study determines the ROC cut off value of specific IgE levels as 0.49KAU/L and total IgE levels of 1204 IU/L for the diagnosis of children with ABPA.