MYCOLab Ai Logo - gold and army green

The 2024 International Society for Human and Animal Mycology (ISHAM)-ABPA working group guidelines: Transforming diagnosis and management of ABPA

Summary

ABPA is a serious lung disease that develops when the body overreacts to a common fungus called Aspergillus. New international guidelines help doctors better diagnose and treat this condition, which affects many people with asthma and cystic fibrosis. The guidelines make diagnosis easier by using simpler tests and lowering the thresholds for detecting the disease, and they provide clear treatment plans depending on how severe each patient’s disease is. These updated standards are especially important in countries like India where ABPA is very common.

Background

Allergic bronchopulmonary aspergillosis (ABPA) is a pulmonary disorder caused by an exaggerated immune response to Aspergillus species, particularly among patients with asthma and cystic fibrosis. Previous diagnostic criteria were established in 2013, but advances in diagnostics and therapeutics necessitated updates. India has a high burden of ABPA with prevalence almost twice the global average, yet nearly one-fifth of cases are still misdiagnosed as pulmonary tuberculosis.

Objective

To present updated 2024 ISHAM-ABPA working group guidelines that standardize and optimize the diagnosis, classification, and treatment of ABPA and allergic bronchopulmonary mycosis (ABPM). The guidelines incorporate recent evidence and expert consensus to improve clinical practice and patient outcomes.

Results

The updated guidelines introduced significant changes including expanded definition of ABPA to include all Aspergillus species, lowered serum total IgE cutoff to ≥500 IU/mL, universal screening recommendations for asthma patients using A. fumigatus-IgE, consolidated classification into five clinical states, and refined treatment frameworks based on disease severity with multiple therapeutic options.

Conclusion

The 2024 ISHAM-AWG guidelines mark a significant milestone in ABPA diagnosis and management by offering a streamlined approach incorporating recent evidence and expert consensus. While knowledge gaps persist, these guidelines lay groundwork for future research and improved patient outcomes, with collaboration across disciplines essential for translation into clinical practice.
  • Published in:Lung India,
  • Study Type:Guidelines, Expert Consensus Review,
  • Source: PMID: 40013623, PMC11952734
Scroll to Top