ABPA is more common than was once suspected, while it remains likely that ABPF is rare. The spectrum of ABPA ranges from mild asthma to end-stage fibrotic lung disease. The episodes of chest roentgenographic infiltrates may be associated with little symptomatology and their detection is made by serial measurement of total serum IgE. A useful serodiagnostic aid for identification of early cases of ABPA is the demonstration of elevated IgE and IgG antibodies to Af compared with patients with asthma who do not have ABPA. Such assays are helpful in childhood cases of ABPA and in cystic fibrosis where no other test is as sensitive and specific. Prednisone remains the treatment of choice and, in many cases, its use can be intermittent.
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