Value of eosinophil count in bronchoalveolar lavage fluid for diagnosis of allergic bronchopulmonary aspergillosis: A case report

Table 1 Diagnostic criteria for allergic bronchopulmonary aspergillosis

Rosenberg ’s criteria (1977) [6]
Major criteria	(1) Asthma; (2) Presence of fleeting or fixed pulmonary opacities on chest radiograph; (3) Immediate cutaneous hypersensitivity reaction to A. fumigatus; (4) Total serum IgE more than 1000 IU/mL; (5) Precipitating antibodies against A. fumigatus; (6) Peripheral-blood eosinophilia; and (7) Central or proximal bronchiectasis with normal tapering of distal bronchi
Minor criteria	(1) Golden-brown sputum plugs in expectorant; (2) Positive sputum culture for Aspergillus species; and (3) Late (arthus-type) skin reactivity to A. fumigatus
The ISHAM Working Group’s criteria (2013) [8]
Predisposing conditions	(1) Asthma; and (2) Cystic fibrosis
Obligatory criteria (both criteria must be fulfilled)	(1) Positive immediate (type I) cutaneous hypersensitivity to Aspergillus antigen or elevated IgE levels against A. fumigatus; and (2) Total IgE levels > 1000 IU/mL
Other criteria (at least 2 out of 3 must be fulfilled)	(1) Presence of precipitating or IgG antibodies against A. fumigatus in serum; (2) Radiographic pulmonary opacities consistent with ABPA; and (3) Total eosinophil count > 500 cells/μL in steroid-naïve patients
New Clinical Diagnostic Criteria in Japan (2020) [9]
	(1) History of asthma or symptoms associated with asthma; (2) Blood eosinophils ≥ 500/μL; (3) Blood total IgE ≥ 417 IU/mL; (4) Positive findings in the type 1 mycosis skin test or specific IgE; (5) Positive findings of mycosis-specific precipitating antibodies or specific IgG; (6) Detection of mycosis in sputum or bronchoscopy specimen; (7) Positive findings of mycotic mycelium by Grocott staining of the mucus plug; (8) Dilatation of the central bronchus on chest CT; (9) Current or historical mucus plug existence on chest CT or bronchoscopy; and (10) Presence of high-attenuation mucus on chest CT (ABPA is diagnosed if more than 6 criteria are satisfied in a patient without cystic fibrosis).

ABPA: Allergic bronchopulmonary aspergillosis; IgE: Immunoglobulin E; IgG: Immunoglobulin G; IU: International units; A. fumigatus: Aspergillus fumigatus; CT: Computed tomography.