Unifying Concepts

Diagnostic Criteria for Allergic Bronchopulmonary Aspergillosis (ABPA)

The diagnostic criteria for ABPA include a history of asthma, evidence of Aspergillus fumigatus (A. fumigatus) IgE sensitisation on blood and/or skin tests, elevated total IgE levels and eosinophil counts, detection of Aspergillus precipitins or IgG, isolation of A. fumigatus in sputum cultures, presence of pulmonary infiltrates on chest x rays and distribution of bronchiectasis on CT chest scans.

Diagnostic Criteria for Allergic Bronchopulmonary Aspergillosis

Essential criteria

  • Asthma or cystic fibrosis
  • Elevated Aspergillus-specific IgE or Aspergillus skin test positivity
  • Elevated serum IgE (> 1000 ng/mL or > 417 IU/mL)*

Other criteria

  • Precipitating serum antibodies to A. fumigatus or elevated serum Aspergillus IgG by immunoassay
  • Radiographic pulmonary opacities consistent with allergic bronchopulmonary aspergillosis
  • Blood eosinophilia (> 500 cells/mcL [> 0.5 × 109/L) currently or previously while corticosteroid-naive

* May be lower if patient meets all other criteria for diagnosis.



  1. Agarwal R, Chakrabarti A, Shah A, Gupta D, Meis JF, Guleria R, Moss R, Denning DW; ABPA complicating asthma ISHAM working group. Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria. Clin Exp Allergy. 2013 Aug;43(8):850-73. [Medline]
  2. Hill AT, Sullivan AL, Chalmers JD, De Soyza A, Elborn SJ, Floto AR, Grillo L, Gruffydd-Jones K, Harvey A, Haworth CS, Hiscocks E, Hurst JR, Johnson C, Kelleher PW, Bedi P, Payne K, Saleh H, Screaton NJ, Smith M, Tunney M, Whitters D, Wilson R, Loebinger MR. British Thoracic Society Guideline for bronchiectasis in adults. Thorax. 2019 Jan;74(Suppl 1):1-69. [Medline]


Created May 29, 2023.


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