Cutoffs of diagnostic criteria for allergic bronchopulmonary aspergillosis in asthmatic children

Background: Currently used diagnostic criteria for allergic bronchopulmonary aspergillosis (ABPA) are from adult literature and are not validated in children. We aimed to evaluate the performance of currently used diagnostic criteria for ABPA and to propose new cutoff values for ABPA in asthmatic children. Methods: In this retrospective cohort study, we recorded clinical details and diagnostic criteria for ABPA in asthmatic children. We used the receiver operating characteristic curve to determine the diagnostic utility of currently used cutoff values and Youden’s index to determine the best cutoff values. Results: We included 119 children, of whom 23 had ABPA. The area under the curve for currently used cutoffs of total immunoglobulin E (IgE), Aspergillus-specific IgE, Aspergillus-specific immunoglobulin G (IgG), and absolute eosinophil counts (AEC) were 0.801, 0.873, 0.634, and 0.765, respectively. The proposed best cutoff values of total IgE, Aspergillus-specific IgE, AEC, and Aspergillus-specific IgG were 1000 IU/mL, 0.53 kUA/L, 665/mm3, and 16.8 mg/L, respectively, with a sensitivity and specificity of 100% and 60.2%, 87.5% and 82.5%, 93.8% and 67.0%, and 63.6% and 68.5%, respectively. Conclusion: Currently uses criteria for ABPA may not be appropriate for children. We propose new cutoff values for ABPA in asthmatic children.