964 allergic bronchopulmonary aspergillosis (abpa) with low serum ige


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ABSTRACT Elevated serum IgE is helpful in making the diagnosis of ABPA and in monitoring the onset of exacerbation and response to therapy. ABPA occurs frequently in patients with cystic


fibrosis (CF). They also develop high total serum IgE. A 20 yr. old non-asthmatic woman with CF who smoked marihuana developed fever, chest pain and expectoration of brown flecks. She had a


ligularinfiltrate, blood(1500/mm3) and sputum(50%) esoinopilia.Sputum cultures were positive for Aspergillus fumigatus (Af). A previously negative immediate skin test to Af became positive


(1:10,000 w/v). She developed serum precipitins to antigens from two Af sources and to Aspergillus species isolated from her marihuana.Septate hyphae were seen in a left upper lobe bronchial


brushing. Culture grew Af. Three mos. prior to the acute illness IgE was 9 IU/ml. Serum IgE rose to 16 and 29 IU/ml. during 10 days when the Dx of ABPA was being considered. With prednisone


Rx symptoms disappeared, chest infiltrate cleared, culture for Af became negative, Af precipitin tests became negative and IgE fell to 6 IU/ml. The immediate skin test to Af remained


positive 3 mos. after Dx. Af RAST's were negative 4 yrs. and 3 mos, prior to the illness, at the time of acute illness and at 3 mo. intervals after onset. Serum skin sensitizing


antibody could not be detected by P-K passive transfer and skin testing at 2 hrs. and 48 hrs. Elevated total serum IgE does not always accompany acute ABPA. Early diagnosis may need to be


made using less restricted criteria. ARTICLE PDF AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * University of Rochester, School of Medicine and Dentistry. Dept. of Pediatrics, Rochester, New


York Robert H Schwartz & Gary E Hollick Authors * Robert H Schwartz View author publications You can also search for this author inPubMed Google Scholar * Gary E Hollick View author


publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Schwartz, R., Hollick, G. 964


ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS (ABPA) WITH LOW SERUM IgE. _Pediatr Res_ 15 (Suppl 4), 603 (1981). https://doi.org/10.1203/00006450-198104001-00989 Download citation * Issue Date: 01


April 1981 * DOI: https://doi.org/10.1203/00006450-198104001-00989 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a


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