The Implications of Hypersensitivity Pneumonitis (HP) Precipitin Assays in the Diagnosis of Immune Lung Diseases

M.R. Murali

Author address: 

Medicine, Division of Rheumatology, Allergy and Clinical Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA

Abstract: 

RATIONALE: To examine the the diagnostic contribution of HP testing based on analyses of positive precipitin assays (PA) in lung diseases. METHODS: Sera from 178 subjects were tested for PA in the HP panel in a 12 month period. 35 of 178 (19.6%) of samples yielded a positive precipitin test. Antigen panel included Aspergillus species (Asp) - A.fumigatus (Af), A.flavus (A.fl), A.niger (An), T.Sacchari (Ts), T.candidus (Tc), T.vulgaris (Tv), S.virides (Sv), M.faeni (Mf), pigeon serum (Ps) and A.pullulans(Ap). Precipitating antibodies to this antigen panel was evaluated by Ouchterlony double diffusion on agarose plates and positve results validated for specificity and reproducibility. RESULTS: (a) The most common PA was to Ts(20), followed by Ap(7), Af(7), Afl(7), An(4), Tc(3) and Ps(2). None had PA to Tv,Sv and Mf. (b)Inclusion of Afl and An enabled detection of PA in 11 additional subjects. Af PA was present in 7 subjects only. (c)The spectrum of lung diseases ranged from asthma (11),acute interstitial lung diseases (ILD) (9), chronic ILD (7). In these Ts>Asp>Ap. ABPA (4) were all due to Asp. BOOP (3) was associated with Ap and 1 normal subject had PA to Ts. CONCLUSIONS: 1.Subjects with PA have a wide spectrum of non-infectious lung diseases. 2. By including all 3 Asp the diagnostic sensitivity of Asp associated lung diseases is increased. 3.HP tests not incorporating Ap and Ts antigens are likely to be diagnostically inferior.
2006

abstract No: 

88

Full conference title: 

2006 American Academy of Allergy, Asthma, and Immunology Annual Meeting
    • AAAAI 2006 (62nd)