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

Summary

Allergic bronchopulmonary aspergillosis (ABPA) is a serious lung condition that develops when people with asthma have an allergic reaction to Aspergillus fungus. New international guidelines now provide better ways to diagnose and treat this condition, making it easier for doctors to identify ABPA early and prescribe the right treatment to prevent serious lung damage like bronchiectasis.

Background

Allergic bronchopulmonary aspergillosis (ABPA) is a pulmonary disorder caused by an exaggerated immune response to Aspergillus species, particularly in patients with asthma and cystic fibrosis. The condition can lead to severe pulmonary complications including bronchiectasis if not diagnosed and treated appropriately. India has a high burden of ABPA with prevalence almost twice the global average.

Objective

To present the updated 2024 ISHAM-ABPA working group guidelines that incorporate recent advances in diagnostics and therapeutics to standardize and optimize the diagnosis, classification, and treatment of ABPA and allergic bronchopulmonary mycosis (ABPM).

Results

Key updates include expanded definition of ABPA to include all Aspergillus species, refined diagnostic criteria with lowered serum total IgE cut-off (≥500 IU/mL), universal screening recommendations for ABPA in adult asthma patients, new classification into five clinical states, and updated treatment framework based on disease severity with specific recommendations for different patient populations.

Conclusion

The revised 2024 ISHAM-AWG guidelines provide a streamlined approach to diagnosing and managing ABPA by incorporating recent evidence and expert consensus. These guidelines lay groundwork for future research and improved patient outcomes, with ongoing collaboration across disciplines essential for translating guidelines into clinical practice.
  • Published in:Lung India,
  • Study Type:Clinical Practice Guidelines, Expert Consensus,
  • Source: PMID: 40013623, DOI: 10.4103/lungindia.lungindia_28_25
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