Application of the ISHAM criteria for diagnosis of ABPA in a clinical cohort at a university teaching hospital

Introduction: Allergic Bronchopulmonary Aspergillosis(ABPA) complicates course of patients with asthma. Previously ABPA diagnostic criteria lacked a consistent case definition. In 2013, ISHAM criteria for ABPA diagnosis in asthmatics was published which included(1): Obligatory critera(both should be present) Total IgE>1000IU/ml +ve Aspergillus specific(Af) IgE or skin prick test Other criteria(2 out of 3) Raised Af IgG or precipitins Eosinophils>500 cells/uL Radiological features consistent with ABPA Aim: To identify the proportion of patients diagnosed with ABPA at our centre that fulfilled the ISHAM criteria atleast once. Methods: We identified 111 patients diagnosed with ABPA at NNUH between 2007-2017 through retrospective search of clinic letters, radiology and laboratory tests. Results: ABPA diagnosis by the ISHAM criteria was confirmed in 73(66%) patients. Breakdown of individual test results are summarised in Table 1. Conclusion: Our study demonstrates the difficulty in applying the ISHAM criteria to historic cohorts and our results are similar to the study by Page et al(2). The ISHAM criteria are a huge step in standardising the diagnosis of ABPA for future clinical and research studies. Table 1 1. Agrawal et al. Clin Exp Allergy.2013;43(8):850-73 2. Page et al. ECCMID 2017, P0941