Aspergillus Fumigatus Precipitins

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Division of Laboratory Medicine Immunology Aspergillus fumigatus precipitins General information Precipitin testing: These tests detect the presence of IgG antibodies to Aspergillus fumigatus, Aspergillus precipitins - see also: Farmer's lung and Avian Precipitins Specimen transport: At room temperature Repeat frequency: On appearance of new symptoms Special precautions: None Laboratory information Normal reference range: 0-40 mg/L Volume and sample type: 7ml clotted blood Method: FEIA (Fluoroenzyme immunoassay) Turnaround time (calendar days from sample receipt to authorised result): Median – 4 Participation in EQA Scheme: UK NEQAS for FUNGAL and RELATED ANTIGENS Clinical information Indications for the test: Allergic bronchopulmonary aspergillosis - IgG antibodies are a useful aid to diagnosis in the following settings: • Bronchopulmonary aspergillosis; usually presents as deteriorating or brittle asthma. IgE antibodies should also be checked. • Aspergilloma; these may form in cavities or bronchiectatic lung. For example, this test is used to check for aspergilloma in patients with cystic fibrosis. • Hypersensitivity pneumonitis 24 hours after inhalation of spores. Factors affecting the test: Aspergillus antibodies are not a recommended test for the investigation of the majority of cases of invasive aspergillosis in immunocompromised hosts. Interpreting results: IgG antibodies are infrequent in healthy individuals. 1/2 mft.nhs.uk/laboratorymedicine 1/2 Division of Laboratory Medicine Immunology In hypersensitivity pneumonitis, IgG antibodies are usually present alone. IgG antibodies, without IgE antibodies can also be seen in some cases of sub acute invasive aspergillus. In bronchopulmonary aspergillosis and aspergilloma a mixture of IgE and IgG antibodies are usually present. Bronchopulmonary aspergillosis can be caused by species other than A. fumigatus: if there is a high index of suspicion, we can send a sample to the reference laboratory to look for antibodies to other Aspergillus species. In allergic rhinitis and asthma, where aspergillus is a relevant allergen, IgE antibodies dominate. ICE reference: Aspergillus Precipitins (Last updated December 2020) 2/2 mft.nhs.uk/laboratorymedicine 2/2 .

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