Allergic bronchopulmonary aspergillosis in Italian cystic fibrosis patients: Prevalence and percentage of positive tests in the employed diagnostic criteria

The prevalence of allergic bronchopulmonary aspergillosis (ABPA) in cystic fibrosis (CF) patients is difficult to determine because the data in the li terature are not homogeneous or comparable. ABPA and CF have similar clinic al symptoms which make diagnosis difficult and underestimate the real dimen sions of the problem. We conducted an epidemiological study on 3089 Italian CF patients to determine the prevalence of ABPA in Italy and verify the pe rcentage of positive tests in the employed diagnostic criteria. Our results indicate that the prevalence of ABPA in Italian CF patients is 6.18%, main ly in adolescents and young adults. ABPA is diagnosed using clinical sympto ms (presence of episodic bronchial obstructions or typical radiographic fea tures) and on the basis of other criteria which can only be partially fulfi lled in paediatric patients. Among the diagnostic tests the most sensitive are the total IgE (84.5%), specific IgE anti-Aspergillus fumigatus (81.6%) and the prick test (68.3%). In the absence of clinical symptoms and gold st andard diagnostic tests, serological positivity and/or the skin test are no t sufficient evidence to confirm the presence of ABPA.