Screening
Screening for allergic bronchopulmonary aspergillosis (ABPA) is not done in the general asymptomatic population, but it should be considered in certain subgroups, such as patients with atopic asthma and cystic fibrosis (CF) patients.
Asthma
The recommended initial screening test for patients with asthma is testing for total IgE and aspergillus-specific IgE either through RAST testing in the blood or via skin prick testing.[26] Further serological and radiographic evaluation is then required to determine whether minimal diagnostic criteria are met.
Cystic fibrosis
Recommended screening measures for ABPA in patients with CF, as outlined by the Cystic Fibrosis Foundation, include having a high level of clinical suspicion (such as deterioration in pulmonary status and an abnormal chest x-ray in any CF patient older than 6 years, measuring serum total IgE annually, and obtaining immediate cutaneous testing to A fumigatus antigenic extract if serum total IgE is >500 kilounits/L. A diagnosis of ABPA should be considered in the light of other criteria for diagnosis in CF patients.[34]
If serum total IgE is 200 to 500 kilounits/L, the measurement should be repeated. If clinical suspicion is high, other diagnostic testing of serum Aspergillus-specific IgE and serum precipitating antibodies (serum precipitins) should be considered.[34]
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