A case report of allergic fungal rhinosinusitis managed with Dupilumab.

Autor:	Alotaibi NH; Department of Otolaryngology-Head & Neck, King Faisal Specialist Hospital and Research Center (KFSH&RC), Riyadh, Saudi Arabia; Department of Surgery, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia., Aljasser LA; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. Electronic address: laljasser@alfaisal.edu., Arnaout RK; Section of Allergy/Immunology, Department of Medicine, King Faisal Specialist Hospital and Research Center (KFSHR&RC), Riyadh, Saudi Arabia; Department of Medicine, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia., Alsomaili S; Section of Allergy/Immunology, Department of Medicine, King Faisal Specialist Hospital and Research Center (KFSHR&RC), Riyadh, Saudi Arabia.
Jazyk:	angličtina
Zdroj:	International journal of surgery case reports [Int J Surg Case Rep] 2021 Nov; Vol. 88, pp. 106479. Date of Electronic Publication: 2021 Oct 07.
DOI:	10.1016/j.ijscr.2021.106479
Abstrakt:	Introduction: Allergic fungal rhinosinusitis (AFRS) is a subtype of chronic rhinosinusitis with nasal polyps. It is characterized by eosinophilic mucin, which results from an inflammatory reaction to non-invasive fungal hyphae in the rhino-sinuses. It is clinically recognizable due to the criteria set by Bent and Kuhn. The treatment approach is multimodal, and the main treatment approach is surgical debridement, followed by a course of oral and/or topical corticosteroids to decrease recurrence post-surgery. This case report aims to illustrate the effect of Dupilumab, on the number of relapse episodes in a patient and the associated parameters. Case Presentation: Herein we report a case of a 40-year-old woman referred to our institution as a case of refractory AFRS for which she underwent four functional endoscopic sinus surgeries (FESS) and was on maximum medical treatment. She presented with complaints of facial fullness and pain, headache, and purulent discharge. After another trial of surgery which did not control her symptoms, she was assessed for criteria to start biological treatment. The symptoms were successfully controlled after initiation of the agent, and she was followed up using multiple subjective and objective measures. Conclusion: AFRS is a non-invasive immune-mediated sub-clinical entity of chronic rhinosinusitis. A multimodal approach to its treatment based on surgical debridement with medical therapy has shown positive outcomes. In this case we present significant improvement after administering Dupilumab; therefore, suggesting its addition to the treatment regimen of refractory AFRS. (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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