Sorted By Test Name - Mayo Medical Laboratories

SASP
9678
ASPG
86324
Aspergillus fumigatus, IgG Antibodies, Serum
Clinical Information: Aspergillus fumigatus is a causative agent of hypersensitivity pneumonitis
(HP) as well as invasive lung disease with cavitation or pneumonitis, and allergic bronchopulmonary
disease.(1) Other causative microorganisms of HP include Micropolyspora faeni, and Thermoactinomyces
vulgaris. The development of HP and allergic bronchopulmonary disease caused by Aspergillus fumigatus
is accompanied by an immune response to Aspergillus fumigatus antigen with production of IgG or IgE
antibodies, respectively. While the immunopathogenesis of HP and allergic bronchopulmonary disease is
not known, several immune mechanisms are postulated to play a role, including both cellular and humoral
mechanisms.
Useful For: Evaluating patients suspected of having lung disease caused by Aspergillus fumigatus
Interpretation: Elevated concentrations of IgG antibodies to Aspergillus fumigatus,
Thermoactinomyces vulgaris, or Micropolyspora faeni in patients with signs and symptoms of
hypersensitivity pneumonitis is consistent with disease caused by exposure to 1 or more of these organic
antigens. Extreme elevations (>5 times the upper limit of normal) occur in some patients with active
disease.
Reference Values:
or =4 years: < or =102 mg/L
Clinical References: 1. Fink JN, Zacharisen MC: Hypersensitivity pneumonitis. In Allergy
Principles and Practice. Vol. 1. Fifth edition. Edited by E Middleton Jr, CE Reed, EF Ellis, et al. St.
Louis, Mosby Year Book Inc., 1998, Chapter 69 2. Anderson E, Jacob GL, Roberts GD, Homburger HA:
Comparative evaluation of enzyme immunoassay and immunodiffusion for detection of IgG antibodies to
hypersensitivity pneumonitis antigens. Poster Presentation, AAAAI Annual Meeting, San Diego, March
3-8, 2000. J Allergy Clin Immunol 2000;105:S304
Aspergillus niger, IgE
Clinical Information: Clinical manifestations of immediate hypersensitivity (allergic) diseases are
caused by the release of proinflammatory mediators (histamine, leukotrienes, and prostaglandins) from
immunoglobulin E (IgE)-sensitized effector cells (mast cells and basophils) when cell-bound IgE
antibodies interact with allergen. In vitro serum testing for IgE antibodies provides an indication of the
immune response to allergen(s) that may be associated with allergic disease. The allergens chosen for
testing often depend upon the age of the patient, history of allergen exposure, season of the year, and
clinical manifestations. In individuals predisposed to develop allergic disease(s), the sequence of
sensitization and clinical manifestations proceed as follows: eczema and respiratory disease (rhinitis and
bronchospasm) in infants and children less than 5 years due to food sensitivity (milk, egg, soy, and wheat
proteins) followed by respiratory disease (rhinitis and asthma) in older children and adults due to
sensitivity to inhalant allergens (dust mite, mold, and pollen inhalants).
Useful For: Testing for IgE antibodies may be useful to establish the diagnosis of an allergic disease
and to define the allergens responsible for eliciting signs and symptoms. Testing also may be useful to
identify allergens which may be responsible for allergic disease and/or anaphylactic episode, to confirm
sensitization to particular allergens prior to beginning immunotherapy, and to investigate the specificity of
allergic reactions to insect venom allergens, drugs, or chemical allergens.
Interpretation: Detection of IgE antibodies in serum (Class 1 or greater) indicates an increased
likelihood of allergic disease as opposed to other etiologies and defines the allergens that may be
responsible for eliciting signs and symptoms. The level of IgE antibodies in serum varies directly with the
concentration of IgE antibodies expressed as a class score or kU/L.
Reference Values:
Class IgE kU/L Interpretation
0 Negative
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