Galactomannan testing in the treatment of autoimmune disease combined with invasive fungal disease

Abstract

Invasive fungal disease (IFV) has a high incidence among autoimmune disease patients who have poor immunity. Diagnosis of IFD is difficult in the early stage. Conventional imaging technologies are poor in sensitivity, specificity and detection rate, therefore, an effective method is needed for improving the diagnosis of autoimmune disease complicated with IFD. To study the benefits of galactomannan testing in the diagnosis of IFD, 256 patients who were diagnosed with autoimmune disease in our hospital between December 2014 and December 2016, and who developed pulmonary infection in the process of immunosuppressant treatment, were selected. They were classified into 2 groups: autoimmune disease patients with IFD and those with non-IFD, based on the diagnostic criteria and treatment principles of invasive pulmonary fungal infection. Among the patients with autoimmune disease in combination with IFD, there were 12 confirmed cases, 24 clinically diagnosed cases and 49 suspected cases. The 36 confirmed and clinically diagnosed cases were used as the observation group, while 171 patients with autoimmune disease in combination with non-IFD were placed in the control group. Galactomannan testing was performed on both groups. The results demonstrated that the level of galactomannan in the patients in the observation group were significantly higher than those in the control group (P<0.05). Receiver operating characteristic (ROC) curves revealed that galactomannan testing had high diagnostic value for autoimmune disease combined with IFD. The area under ROC curve was the largest when galactomannan value higher than 0.7 was taken as the positive breakpoint, and the sensitivity and specificity at this critical value were 87.1 and 92.6%, respectively. Therefore it can be concluded that galactomannan testing has important application values in the diagnosis of autoimmune disease in combination with IFD.