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Aspergillus nidulans

Test ID:

704732

CPT code:

86606

Synonyms:

Aspergillus nidulans Precipitating Antibodies, IgG

Composter’s Lung

Hypersensitivity Pneumonitis

Malt-worker’s Lung

Tobacco-worker’s Disease

Clinical Use:

Confirm the presence of precipitating antibodies to Aspergillus nidulans

Test Information:

Hypersensitivity pneumonitis (HP), also referred to as extrinsic allergic alveolitis (EAA), is an inflammatory lung disease resulting from the inhalation and subsequent sensitization to a wide variety of inhaled organic dusts. HP is not mediated by IgE. It is associated with progressive pulmonary disability, irreversible lung damage, and mortality in some occupational settings. Patients often present with intermittent chills, fever, cough, and shortness of breath that begin four to eight hours after exposure to the offending dust.
Aspergillus mold can be found in soil, foods, fresh water, and other natural sources including compost, barley, tobacco, and Esparto grass dust (stucco). These organisms grow well in decaying organic material at temperatures often attained during decomposition. Aspergillus mold can also grow on ceiling and walls where water damage has occurred.
No single laboratory test is diagnostic for hypersensitivity pneumonitis. Diagnosis is based on a complete environmental history supported by result of chest x-ray, spirometry, and in vitro immunologic tests. Identification of the causative agent is important to allow avoidance of exposure. Double diffusion (Ouchterlony) assays are typically used to determine antigen-specific IgG antibodies. The appearance of precipitin arcs confirms the presence of precipitating antibodies to specific antigens. These antibodies may also be present in individuals not afflicted with HP. The presence of antibodies to the offending dust or antigen confirms exposure but is not diagnostic of HP; however, upon repeated or prolonged exposures, high levels of precipitating IgG antibodies are typically observed.
Aspergillus infection can also result in allergic bronchopulmonary aspergillosis (ABPA), a condition where airway colonization of individuals with asthma or cystic fibrosis results in increased inflammation and destruction of bronchial structural elements. Testing for Aspergillus precipitating IgG antibodies has been shown to be of some clinical utility in the assessment of patients with potential ABPA.