What is Allergic Bronchopulmonay Aspergillosis (ABPA)? What is Allergic Bronchopulmonary Mycosis (ABPM)? What is Hypersensitivity Pneumonitis (HP)? Services Collection and handling of sera Mailing Instructions History or Physician Request Form Price List and Billing Information Allergic Bronchopulmonay Aspergillosis (ABPA):Allergic Bronchopulmonary Aspergillosis is a complication in about 1% of patients with persistent asthma and up to 11% of patients with cystic fibrosis. In its classic form, the following criteria are present:
asthma (mild to severe),
history of chest radiograph or computerized tomography infiltrates not explained by other causes,
bronchiectasis (bronchial wall widening) in the inner 2/3 of the lung fields,
positive immediate skin reaction to Aspergillus fumigatus,
elevated total serum IgE concentration (> 417 kU/L in adults),
precipitating antibodies in gel to Aspergillus fumigatus, and
elevated serum IgE and or IgG antibodies to Aspergillus fumigatus compared to sera from patients with asthma who do not have allergic bronchopulmonary aspergillosis.
Some patients may expectorate sputum plugs that contain the fungus, Aspergillus fumigatus. Patients typically are allergic in the sense that they have hay fever (allergic rhinitis) and allergic asthma, and it is not surprising to find that they have some drug allergies, food allergies or current or previous atopic dermatitis (eczema). Allergic Bronchopulmonary Mycosis:Allergic Bronchopulmonary Mycosis refers to a condition resembling allergic bronchopulmonary aspergillosis but in which the tests and supporting information are not consistent with antibodies to Aspergillus fumigatus. Some cases are attributable to other species of the genus Aspergillus such as Fusarium, Curvularia, Cephalosporium, and Penicillium, as examples. Hypersensitivity Pneumonitis: Hypersensitivity pneumonitis (HP) is an immunologic, hypersensitivity lung condition that can cause shortness of breath, coughing, chest constriction or may be silent (no symptoms) while it harms the chest. Various names have been used based on the occupation involved such as farmer’s lung disease, cork worker’s lung, malt worker’s lung and bird breeder’s disease (a form of avian hypersensitivity pneumonitis). In classic cases of avian hypersensitivity pneumonitis, birds that live in the home can trigger the hypersensitivity response that can cause shortness of breath and chest radiograph and pulmonary function test abnormalities. Patients and exposed, but not ill, subjects can have precipitating antibodies in their sera to the potential causative source. A skilled physician can assist in interpreting the test results and the clinical examination of the patient. The information form should be completed so that we can perform the most precise tests. We ask that you identify the type of birds in the home that may be causing the hypersensitivity response. A patient may recognize that within two hours of entering the environment where the bird is located, there is acute shortness of breath or difficulty breathing. However, in other cases, the patient does not detect any symptoms despite the fact that the chest radiograph can be abnormal, and the pulmonary function tests are deteriorating. Avoidance of the birds is advisable as treatment of avian hypersensitivity pneumonitis Top Services: Questions about shipping and prices can be obtained by calling 312-503-0208. Questions about clinical cases can be directed to Dr. Paul A. Greenberger at 312-695-4000 or by fax at 312-695-4141. Collection and handling of sera: Send 2-5 mL of sterile serum per analysis for either allergic bronchopulmonary aspergillosis, allergic bronchopulmonary mycosis or hypersensitivity pneumonitis. For collection, obtain 7-10 mL of blood by venipuncture into a syringe or vacutainer without anticoagulant. If a syringe is used to obtain the blood, transfer the blood to a sterile tube with no anticoagulant. Next, allow the blood to clot for 1-2 hours at room temperature, then centrifuge, harvest the serum and place in a plastic tube suitable for mailing. Label the tube with the patient’s name and the date of the collection.
Sera can be mailed or shipped. If mailed, send first class at room temperature. We must receive the sera within five days of shipping. If shipped, samples do not have to be refrigerated. However, if they are, use a cold pack but not with “wet ice” which will melt. Please do not send overnight delivery packages on Fridays; no one is available on Saturdays to receive them. Mailing Instructions:
For all sera, send to:
Division Allergy-Immunology
Research Laboratory
Attn: Dr. Paul A. Greenberger
McGaw Pavilion M 520 L
240 East Huron Street
Chicago, IL 60611
Phone (312) 503-0208
Fax (312) 908-0210 For payments:
Make check payable to NORTHWESTERN UNIVERSITY DIVISION OF ALLERGY-IMMUNOLOGY
Send to:
Northwestern University Feinberg School of Medicine
Division of Allergy-Immunology
Administrative Offices
676 North St.Clair Street
Suite 14108
Chicago, IL 60611
Physician Request Form: Please complete the request form and mail with the sera or fax it back to 312-908-0210.
Click here to download the History/Physican Request Form Price List and Billing Information: We do not bill patients directly. The invoice and report are sent to the physician or laboratory that requested the test. We typically do not release results to patients.
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