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J Allergy Clin Immunol. 1998 Sep;102(3):387-94.

Evaluation and treatment of allergic fungal sinusitis. I. Demographics and diagnosis.

Author information

1
Allergy Asthma Clinic, Phoenix, Ariz 85013, USA.

Abstract

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.

PMID:
9768578
DOI:
10.1016/s0091-6749(98)70125-3
[Indexed for MEDLINE]

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