Revised ISHAM-ABPA working group clinical practice guidelines for diagnosing, classifying and treating allergic bronchopulmonary aspergillosis/mycoses

• DOI: 10.1183/13993003.00061-2024
• Publication Date: 2024-02-29T16:45:14Z
• Authors: Ritesh Agarwal; Inderpaul Singh S...; Valliappan Muthu; David W. Denning; Arunaloke Chakrab...; Kathirvel Soundappan; Mandeep Garg; Shivaprakash M. R...; Sahajal Dhooria; Darius Armstrong-...; Koichiro Asano; Jean-Pierre Gangneux; Sanjay H. Chotirmall; Helmut J.F. Salzer; James D. Chalmers; Cendrine Godet; Marcus Joest; Iain Page; Parameswaran Nair; P. Arjun; Raja Dhar; Kana Ram Jat; Geethu Joe; Uma Maheswari Kri...; Joseph L. Mathew; Venkata Nagarjuna...; Anant Mohan; Alok Nath; Dharmesh Patel; Jayanthi Savio; Puneet Saxena; Rajeev Soman; Balamugesh Thanga...; Caroline G. Baxter; Felix Bongomin; William J. Calhoun; Oliver A. Cornely; Jo A. Douglass; Chris Kosmidis; Jacques F. Meis; Richard Moss; Alessandro C. Pas...; Danila Seidel; Rosanne Sprute; Kuruswamy Thurai ...; Ashutosh N. Aggarwal
• Keywords: Allergic bronchopulmonary aspergillosis; Clinical Practice; Pulmonary aspergillosis

Background The International Society for Human and Animal Mycology (ISHAM) working group proposed recommendations managing allergic bronchopulmonary aspergillosis (ABPA) a decade ago. There is need to update these due advances in diagnostics therapeutics. Methods An international expert was convened develop guidelines ABPA (caused by Aspergillus spp.) mycosis (ABPM; caused fungi other than adults children using modified Delphi method (two online rounds one in-person meeting). We defined consensus as ≥70% agreement or disagreement. terms “recommend” “suggest” are used when the <70%, respectively. Results recommend screening A. fumigatus sensitisation fungus-specific IgE all newly diagnosed asthmatic at tertiary care but only difficult-to-treat children. diagnosing those with predisposing conditions compatible clinico-radiological presentation, mandatory demonstration of fungal serum total ≥500 IU·mL −1 two following: fungal-specific IgG, peripheral blood eosinophilia suggestive imaging. ABPM considered an ABPA-like presentation normal -IgE. Additionally, requires repeated growth causative fungus from sputum. do not routinely treating asymptomatic patients. oral prednisolone itraconazole monotherapy acute (newly exacerbation), combination recurrent exacerbations. have devised objective multidimensional criterion assess treatment response. Conclusion framed diagnosing, classifying ABPA/M patient research.