Fungal exposure endocrinopathy in sinusitis with growth hormone deficiency

[Guest guest]

Fungal exposure endocrinopathy in sinusitis with growth hormone deficiency:

Dennis-on syndrome

Dennis

Otolaryngologist and Facial Plastic Surgeon, Private Practice, Northside

Hospital, Piedmont Hospital, USA, ddennis@...

on

Endocrinologist, Private Practice, Piedmont Hospital, USA

Luke Curtis

Occupational Physician and Industrial Hygienist, Illinois, USA

Judson Black

Endocrinologist, Private Practice, Northside Hospital, USA

Abstract

A retrospective study was carried out on 79 patients with a history of mold

exposure, fatigue, and chronic rhinosinusitis (CRS) to determine whether there

is a causal relationship between fungal exposure and chronic sinusitis, fatigue,

and anterior hypopituitarism, especially growth hormone deficiency (GHD). Of the

patients, 94% had a history of CRS, endoscopically and/or computed tomography

(CT) confirmed; 100% had chronic fatigue and 100% had either significant history

of indoor mold exposure and/or positive mold plate testing as measured by settle

plates, with an average colony count of 21 (0-4 normal). A total of 62 had

positive mold plate testing and 17 had positive history of mold exposure. Of 75,

73 (97.3%) had positive serum immunoglobulin G (IgG)-specific antibodies to

fungal antigens. Out of 8, 7 were positive for urinary trichothecenes. Resting

levels of insulin-like growth factor 1 (IGF-1) averaged 123 ng/mL (range 43-285,

normal 88-249 ng/mL). Despite normal resting levels of IGF-1, significant

deficiency of serum human growth hormone (GH) was confirmed by insulin tolerance

test (ITT) in 40 of 50 tested. In all, 51% (40/79) were GH deficient. Primary or

secondary hypothyroidism in T3 and/or T4 was seen in 81% (64/79) patients; 75%

(59/79) had adrenocorticotrophic hormone (ACTH) deficiency. Fungal exposure

endocrinopathy likely represents the major cause of GHD, affecting approximately

4.8 million people compared to approximately known 60,000 cases from all other

causes. A literature review indicates a possible mechanism of GHD in fungal

exposure is that the fungal glucan receptors in the lenticulostellate cells of

the anterior pituitary bind to fungal cells wall glucans and activate the innate

immune system, which activates macrophages that destroy the fungus and

lenticulostellate tissue. Treatment of patients included normal saline nasal

irrigations, antifungal and antibiotic nasal sprays, appropriate use of oral

antibiotics and antifungals, facial steamer with CitriDrops. Thymate and/or

Intramax vitamin supplements, hormone replacement, and reduction of indoor mold

levels. Resolution of rhinosinusitis was seen in 93% (41 of 45) of the patients

who achieved a mold count by settling plates of 0-4 colonies. Thirty patients

were unable to lower their mold counts below four colonies and had various

degrees of mucosal disease and fatigue remaining. Fatigue was improved in all 37

patients who received GH and cortisol and/or thyroid hormone, which were

deficient. Fatigue was partially relieved in 7 of the 37 who did not achieve

mold counts of fewer than four colonies.

http://tih.sagepub.com/content/25/9-10/669.abstract

[Guest guest]

J,

whats the date of release for this paper?

From: osisposis <jeaninem660@...>

Subject: [] Fungal exposure endocrinopathy in sinusitis with growth

hormone deficiency

Date: Sunday, September 12, 2010, 6:54 PM

Fungal exposure endocrinopathy in sinusitis with growth hormone deficiency:

Dennis-on syndrome

Dennis

Otolaryngologist and Facial Plastic Surgeon, Private Practice, Northside

Hospital, Piedmont Hospital, USA, ddennis@...

on

Endocrinologist, Private Practice, Piedmont Hospital, USA

Luke Curtis

Occupational Physician and Industrial Hygienist, Illinois, USA

Judson Black

Endocrinologist, Private Practice, Northside Hospital, USA

Abstract

http://tih.sagepub.com/content/25/9-10/669.abstract

[Guest guest]

2009 OCT.

>

> From: osisposis <jeaninem660@...>

> Subject: [] Fungal exposure endocrinopathy in sinusitis with

growth hormone deficiency

>

> Date: Sunday, September 12, 2010, 6:54 PM

>

> Fungal exposure endocrinopathy in sinusitis with growth hormone

deficiency: Dennis-on syndrome

>

> Dennis

>

> Otolaryngologist and Facial Plastic Surgeon, Private Practice, Northside

Hospital, Piedmont Hospital, USA, ddennis@...

>

[Guest guest]

This was published in Toxicology and Industrial Health, Vol 25, 2009

Jack Thrasher, Ph.D.

Toxicologist, Immunotoxicologist, Fetal toxicologist

Cell - 575-937-1150 Cell-Thrasher

Crawley, M.ED., LADC

Trauma Specialist

Cell -775-309-3994

www.drthrasher.org

CC: jeaninem660@...

From: kmtown2003@...

Date: Sun, 12 Sep 2010 21:45:31 -0700

Subject: Re: [] Fungal exposure endocrinopathy in sinusitis with

growth hormone deficiency

J,

whats the date of release for this paper?

From: osisposis <jeaninem660@...>

Subject: [] Fungal exposure endocrinopathy in sinusitis with growth

hormone deficiency

Date: Sunday, September 12, 2010, 6:54 PM

Fungal exposure endocrinopathy in sinusitis with growth hormone deficiency:

Dennis-on syndrome

Dennis

Otolaryngologist and Facial Plastic Surgeon, Private Practice, Northside

Hospital, Piedmont Hospital, USA, ddennis@...

on

Endocrinologist, Private Practice, Piedmont Hospital, USA

Luke Curtis

Occupational Physician and Industrial Hygienist, Illinois, USA

Judson Black

Endocrinologist, Private Practice, Northside Hospital, USA

Abstract

http://tih.sagepub.com/content/25/9-10/669.abstract