Evaluation and treatment of allergic fungal sinusitis. I. Demographics and diagnosis
| Autor: | David W. Goetz, Mark S. Schubert |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male medicine.medical_specialty Allergy Immunology Immunoglobulin E Serology Hypersensitivity medicine Humans Immunology and Allergy Sinusitis Mycosis Retrospective Studies biology medicine.diagnostic_test business.industry Fungi Middle Aged medicine.disease Dermatology Mycoses Evaluation Studies as Topic Immunoglobulin G Erythrocyte sedimentation rate biology.protein Female Allergic bronchopulmonary aspergillosis business Type I hypersensitivity |
| Zdroj: | Journal of Allergy and Clinical Immunology. 102:387-394 |
| ISSN: | 0091-6749 |
| Popis: | Background: Few cases of allergic fungal sinusitis have been systematically evaluated to conclusively confirm working clinical, histopathologic, and serologic diagnostic criteria. Objectives: The objective of this study was to describe 67 consecutive cases of allergic fungal sinusitis, the largest number of cases yet published. Methods: Cases from 1 practice over 8 years were evaluated with a consistent protocol, including skin testing, serum chemistries and serologies, and surgical specimen analysis. Results: All patients were atopic (100%) and had nasal polyposis (100%). They tended to be young (33.3 ± 13.1 years, mean ± SEM), immunocompetent (92%; remaining 8% with low quantitative immunoglobulin but normal function), have slight female preponderance (58%), have a history of hypertrophic rhinosinusitis (100%), report nasal cast production (75%), and have developed their disease in the southwestern United States. Bipolaris spicifera was the most prevalent fungus involved (67%). Total serum IgE (mean 668 IU/mL) and fungal-specific IgG were generally elevated, whereas fungal-specific precipitins and specific IgE were generally negative despite positive fungal-specific immediate hypersensitivity skin tests. Conclusions: Patients with allergic fungal sinusitis tend to have elevated total serum IgE and fungal-specific IgG at diagnosis but not fungal-specific IgE or precipitins. Histopathologic criteria for allergic fungal sinusitis diagnosis are discussed. The southwestern United States appears to be a "hot spot" for the disease, particularly caused by B spicifera . (J Allergy Clin Immunol 1998;102:387-94.) |
| Databáze: | OpenAIRE |
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