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Aspergillus Antigen, Bronchoalveolar Lavage
MessageSendout, Mayo test code: ASPBA
Test Code
LAB1311
Alias/See Also
Aspergillosis
Invasive Aspergillosis
Platelia Aspergillus Ag
Galactomannan
ASPBA
Invasive Aspergillosis
Platelia Aspergillus Ag
Galactomannan
ASPBA
CPT Codes
87305
Preferred Specimen
2 mL in a sterile, leak-proof container
Minimum Volume
1.5 mL
Transport Container
Sterile, leak-proof container
Note: Specimen trap collection containers (with suction catheters attached) will be rejected due to high-risk of leakage and contamination upon opening. Avoid use of these for bronchoalveolar lavage specimens.
Note: Specimen trap collection containers (with suction catheters attached) will be rejected due to high-risk of leakage and contamination upon opening. Avoid use of these for bronchoalveolar lavage specimens.
Transport Temperature
Refrigerated
Specimen Stability
Refrigerated (preferred): 14 days
Frozen: 14 days
Frozen: 14 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Bronchial washing: Reject
Thick/viscous/mucoid specimens: Reject
Specimen in a non-leak proof container: Reject
Thick/viscous/mucoid specimens: Reject
Specimen in a non-leak proof container: Reject
Methodology
Enzyme Immunoassay (EIA)
FDA Status
Approved
Setup Schedule
Monday through Friday, Sunday
Report Available
1-2 days
Limitations
False-positive results are reported to occur at rates of 8% to 14% with this assay when performed on serum. Numerous foods (eg, pasta, rice, etc) contain galactomannan. It is thought that damage to the gut wall by cytotoxic therapy, irradiation, or graft-versus-host disease enables translocation of the galactomannan from the gut lumen into the blood and may be partially responsible for the high false-positive rate of this assay when serum is tested. Whether false-positive results in bronchoalveolar lavage (BAL) fluid are associated with the consumption of certain foods, as is observed in serum samples, remains to be determined.
Other genera of fungi such as Penicillium and Paecilomyces have shown reactivity with the rat EBA-2 monoclonal antibody used in the assay. These species are rarely implicated in invasive fungal disease. Specimens containing Histoplasma antigen may cross-react in the Aspergillus antigen assay. Cross-reactivity with Alternaria species has also been reported.
The specificity of the assay for Aspergillus species cannot exclude the involvement of other fungal pathogens with similar clinical presentations such as Fusarium, Alternaria, and Mucorales.
The performance of the assay has not been evaluated other specimen types such as urine or cerebrospinal fluid.
The assay may exhibit reduced detection of Aspergillus antigen in patients with chronic granulomatous disease or autosomal dominant hyper-IgE syndrome (formerly known as Job syndrome).
The concomitant use of antifungal therapy in some patients with invasive aspergillosis may result in reduced sensitivity of the assay.
Other genera of fungi such as Penicillium and Paecilomyces have shown reactivity with the rat EBA-2 monoclonal antibody used in the assay. These species are rarely implicated in invasive fungal disease. Specimens containing Histoplasma antigen may cross-react in the Aspergillus antigen assay. Cross-reactivity with Alternaria species has also been reported.
The specificity of the assay for Aspergillus species cannot exclude the involvement of other fungal pathogens with similar clinical presentations such as Fusarium, Alternaria, and Mucorales.
The performance of the assay has not been evaluated other specimen types such as urine or cerebrospinal fluid.
The assay may exhibit reduced detection of Aspergillus antigen in patients with chronic granulomatous disease or autosomal dominant hyper-IgE syndrome (formerly known as Job syndrome).
The concomitant use of antifungal therapy in some patients with invasive aspergillosis may result in reduced sensitivity of the assay.
Reference Range
Included with report
Clinical Significance
Aiding in the diagnosis of invasive aspergillosis using bronchoalveolar lavage specimens
Assessing response to therapy
Assessing response to therapy
Performing Laboratory
Mayo Clinic Laboratories, Rochester, Minnesota
Additional Information
Aspergillus Antigen, Bronchoalveolar Lavage
