The diagnostic tool for evaluating allergic bronchopulmonary aspergillosis (ABPA) involves a structured assessment of three key inputs: predisposing conditions, essential immunological components, and additional diagnostic indicators. The logic determines whether the criteria for diagnosing ABPA are met based on these selections.

Evaluate the inputs as follows:

1. **Predisposing Conditions**: Determine if the individual has underlying risk factors or symptoms.
   - Options: "Present" or "Absent"
   - "Present" indicates the existence of conditions like asthma or cystic fibrosis, or similar clinical and radiological features.

2. **Essential Components**: Confirm the presence of necessary immunological markers.
   - Criteria include:
     - Aspergillus fumigatus-specific immunoglobulin E of at least 0.35 kUA/L, or a positive type 1 skin test
     - Serum total immunoglobulin E at or above 500 IU/mL (lower levels might be permissible if other criteria are met)

3. **Other Components**: Assess additional diagnostic factors.
   - Possible selections:
     - Positive results for Aspergillus fumigatus-specific immunoglobulin G
     - Blood eosinophil count of 500 cells/mcL or higher, current or historical
     - CT scan or X-ray findings consistent with ABPA, showing hallmarks like bronchiectasis or mucus plugging

The interpretive logic proceeds as follows:

- If the predisposing conditions are present, and both essential components regarding immunoglobulin levels are satisfied, then further evaluate other components.
- The diagnostic criteria are confirmed if at least two of the three additional diagnostic indicators are fulfilled: positive IgG, elevated eosinophil count, or suggestive imaging.

In essence, the successful meeting of these criteria returns the diagnosis "Diagnostic criteria are met," affirming the conditions for ABPA have been satisfied. Conversely, if these logical parameters are not achieved, the output returns "Diagnostic criteria not met," indicating an absence of sufficient evidence for ABPA diagnosis. This structured approach ensures a comprehensive and reliable assessment based on the presence and alignment of specific medical indicators pertinent to diagnosing ABPA.

The Revised International Society for Human and Animal Mycology (ISHAM) diagnostic criteria for allergic bronchopulmonary aspergillosis is a clinical calculator used to diagnose allergic bronchopulmonary aspergillosis (ABPA), a lung disease caused by an allergic reaction to the fungus Aspergillus. This calculator is applicable to patients with respiratory symptoms, particularly those with asthma or cystic fibrosis, as these individuals are at a higher risk for developing ABPA.

The clinical utility of the ISHAM diagnostic criteria lies in its ability to accurately diagnose ABPA, which can help guide appropriate treatment and management strategies. The criteria include a combination of clinical, radiological, and immunological parameters such as asthma, immediate cutaneous hypersensitivity to Aspergillus, elevated serum IgE levels, and presence of serum specific IgG and IgE antibodies against Aspergillus.

There are no specific exclusion criteria for the use of the ISHAM diagnostic criteria. However, it should be noted that the criteria may not be applicable to patients without respiratory symptoms or those who do not have an allergic reaction to Aspergillus. Additionally, the criteria should be used with caution in patients with other lung diseases, as these conditions may mimic the symptoms of AB

Revised International Society for Human and Animal Mycology (ISHAM) diagnostic criteria for allergic bronchopulmonary aspergillosis

Revised ISHAM-ABPA working group clinical practice guidelines for diagnosing, classifying and treating allergic bronchopulmonary aspergillosis / mycoses.