Diagnostic value of serum precipitins to moulds-antigens in active hypersensitivity pneumonitis

¹ Dept of Biostatistics, University of Franche-Comte, Besançon, France; and SERF (Santé et Environnement Rural, University of Franche-Comté) group, CHU Besançon, France
² SERF (Santé et Environnement Rural, University of Franche-Comté) group, CHU Besançon, France; and Dept of Mycology, CHU Besançon, France
³ GERM’O’P, Dept of Respiratory Diseases, Hopital Louis Pradel, Lyon, France
⁴ SERF (Santé et Environnement Rural, University of Franche-Comté) group, CHU Besançon, France; and Dept of Respiratory Diseases, CHU Besançon, France

^* To whom correspondence should be addressed. E-mail: Gabriel.reboux{at}ufc-chu.univ-fcomte.fr.

	Abstract

Serum precipitins have a controversial diagnostic value in hypersensitivity pneumonitis (HP). Our objective was to assess their diagnostic value by developing scores from a panel of specific antigens tested by 2 techniques (electrosyneresis and double diffusion) to discriminate active HP from other interstitial lung diseases.

Consecutive patients presenting a condition for which HP was considered in the differential diagnosis, were included in the study. All patients underwent the same standardised diagnostic procedure including precipitin tests performed in routine conditions. Clinical manifestations, bronchoalveolar lavage and high-resolution computed tomograph defined the presence or the absence of HP. Receiver operating characteristic curves and logistic regression were used to develop the serological scores.

122 patients (31 cases of HP) were included. Five antigens from the panel were selected for the serological scores (Absidia corymbifera, Eurotium amstelodami, Wallemia sebi, Saccharopolyspora rectivirgula and mesophilic Streptomyces sp.). Electrosyneresis was more discriminative than the double-diffusion technique. Predictive negative values varied from 81% to 88% and predictive positive values varied from 71% to 75% for prevalences of hypersensitivity pneumonitis from 20% to 35%.

Serological scores using a panel of relevant antigens may guide both biological practice and clinical practice in areas of high prevalences of hypersensitivity pneumonitis.