Mayo researcher / AFS paper

[Guest guest]

Dr. of Mayo was involved here.

Note the reference to IgE mediated hypersensitivity not being observed

in the majority of patients. Does this mean that it could be observed

in up to 49% of cases?

Source: PubMed

The diagnosis and incidence of allergic fungal sinusitis.

Ponikau JU, Sherris DA, Kern EB, Homburger HA, Frigas E, Gaffey

TA, GD.

Department of Otorhinolaryngology, Mayo Clinic Rochester, Minn

55905, USA.

OBJECTIVE: To reevaluate the current criteria for diagnosing

allergic fungal sinusitis (AFS) and determine the incidence of AFS in

patients with chronic rhinosinusitis (CRS). METHODS: This prospective

study evaluated the incidence of AFS in 210 consecutive patients with

CRS with or without polyposis, of whom 101 were treated surgically.

Collecting and culturing fungi from nasal mucus require special

handling, and novel methods are described. Surgical specimen handling

emphasizes histologic examination to visualize fungi and eosinophils

in the mucin. The value of allergy testing in the diagnosis of AFS is

examined. RESULTS: Fungal cultures of nasal secretions were positive

in 202 (96%) of 210 consecutive CRS patients. Allergic mucin was found

in 97 (96%) of 101 consecutive surgical cases of CRS. Allergic fungal

sinusitis was diagnosed in 94 (93%) of 101 consecutive surgical cases

with CRS, based on histopathologic findings and culture results.

Immunoglobulin E-mediated hypersensitivity to fungal allergens was not

evident in the majority of AFS patients. CONCLUSION: The data

presented indicate that the diagnostic criteria for AFS are present in

the majority of patients with CRS with or without polyposis. Since the

presence of eosinophils in the allergic mucin, and not a type I

hypersensitivity, is likely the common denominator in the

pathophysiology of AFS, we propose a change in terminology from AFS to

eosinophilic fungal rhinosinusitis.

PMID: 10488788 [PubMed - indexed for MEDLINE]