Aspergillus antibodies

Question

Hello,

our child’s (7 years old, CF) latest blood test showed aspergillus antibodies. What does that mean, and can we do something about it?

Many thanks in advance!

Answer

Hello,

This question is not so easy to answer, since some additional information is missing.

Aspergillus fumigatus, also known as “watering can mould,” occurs all over the world and is able to survive in almost any surroundings. This fungus belongs to the most widely spread living organisms. Proof of sensitization against aspergillus (specifically increased aspergillus IgE) first of all simply means that your child’s immune system reacts to this allergen. All of us inhale ca. 200 aspergillus spores every day. However, only very few people become sensitive to this mould fungus. Your child has cystic fibrosis, which is a chronic infectious disease of the lungs. Therefore, with an existing inflammation and dysfunctional bronchial cleaning, there is an increased risk of reacting to this mould fungus.

Aspergillus antibodies were detected. Now further questions have to be clarified. How high is your child’s overall IgE value? The IgE development over the past months and years is also particularly important. Patients with CF are power stations concerning their immune system. This means they are not in danger of falling sick of a fungus infection spreading through their bloodstream. However, very severe mould asthma may develop, which then would have to be treated very quickly. This disease is called “bronchopulmonary aspergillosis (ABPA).” In order to find the best possible time to start therapy (cortisone, fungus agents), which can be heavy on side effects, it is crucial to know the IgE development and the specific IgE.

It is equally important to pay attention to symptoms. Unfortunately there are no typical troubles in ABPA. Nevertheless, it is important to look out for certain symptoms and then talk to your doctor about them. Are there hints of an increasing constriction of the bronchia, whistling breathing sounds, shortness of breath, lack of physical fitness or changing colour of the sputum? Failure to respond to antibiotics therapy can also be a hint. By the way, even with a strong sensitization against aspergillus, we are very often not able to find proof of it in the sputum or throat swab.

Can one protect oneself from aspergillus? You cannot completely avoid contact with aspergillus (see above), but you could possibly limit it. Indoor plants, garden work, waste disposal, construction sites, remodelling/renovation measures, etc. are important issues for your next appointment with your CF centre.

Kind regards,
Dr. Olaf Eickmeier

21.10.2013