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Medicine Respiratory 839626ec

All are features of allergic bronchopulmonary aspergillosis except:

A
| Ig A
B
| IgE
C
Eosinophil > 109 /liter
D
Demonstration of hyphae in sputum
High-Yield Explanation
Ans: a (Increased IgA) Ref: Harrison, 16th ed, p. 296,17th ed, p. 1610Definitive major and minor criterias are defined for allergic bronchopulmonary aspergillosis. Increased IgA level is not mentioned in this criteria.Major diagnostic criteria for ABPA:1. Clinical history of asthma2. Pulmonary infiltrates (transient or fixed)3. Peripheral eosinophilia (> 1000/mL)4. Immediate skin reactivity to aspergillus antigen.5. Serum precipitates to A. fumigatus6. Elevated serum IgE levels.7. Central / proximal bronchiectasisSecondary diagnostic criteria1. History of brownish plugs in sputum2. Culture of A. fumigatus from sputum3. Late skin reactivity to aspergillus antigen4. Elevated IgE (and IgG) class antibodies specific for A. fumigatus.

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