The role of total and specific
IgE in monitoring treatment responses in
allergic bronchopulmonary aspergillosis (ABPA) remains poorly studied. Here in, we evaluate the utility of total and Aspergillus fumigatus specific
IgE in the follow-up of ABPA. Eighty-one consecutive treatment-naïve patients of ABPA (acute stage) with pulmonary infiltrates and
bronchiectasis underwent measurement of total and A. fumigatus specific
IgE at baseline, after 8 weeks of
glucocorticoid therapy, and during exacerbations. There was clinical and radiological improvement
after treatment with median decline of total
IgE by 51.9%. The total
IgE declined by at least 35%, 25% and 20% in 69 (85.2%), 76 (93.6%) and 78 (96.3%) patients, respectively. On the other hand, the A. fumigatus specific
IgE increased in 42 (51.9%) subjects, and the mean increase was 1.4%, after 8 weeks. Among 13 patients with exacerbation, 12 (92.3%) had a rise of total
IgE by >50%. The A. fumigatus specific
IgE increased in only five (38.5%) subjects during exacerbation. Thus, the total
IgE is a useful test in monitoring treatment responses in ABPA while A. fumigatus specific
IgE has limited utility.