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Eosinophilic mucus chronic rhinosinusitis: clinical subgroups or a homogeneous pathogenic entity?
Harshita Pant1, Frank E Kette, William B Smith
1Department of Surgery-Otorhinolaryngology Head and Neck Surgery, Universities of Adelaide and Flinders, and the Department of Clinical Immunology, Royal Adelaide Hospital, Adelaide, South Australia.
The Laryngoscope
|July 11, 2006
Summary
Eosinophilic mucus chronic rhinosinusitis (EMCRS) subclassification based on fungal allergy is not clinically distinct. However, EMCRS with eosinophilic mucus indicates a more severe sinus disease.
Area of Science:
- Otolaryngology
- Immunology
- Allergy
Background:
- Eosinophilic mucus chronic rhinosinusitis (EMCRS) is subclassified by fungal presence and allergy.
- Allergic fungal sinusitis (AFS) was considered an IgE-driven disease distinct from other EMCRS subgroups.
- Recent studies questioned the role of allergy in AFS pathogenesis.
Purpose of the Study:
- To examine clinical features of EMCRS subgroups.
- To determine the relevance of the current EMCRS classification system.
Main Methods:
- Prospective examination of demographic, clinical, and immunologic characteristics of EMCRS subgroups.
- Comparison with healthy volunteers, allergic rhinitis with fungal allergy, and chronic rhinosinusitis without eosinophilic mucus control groups.
Main Results:
- EMCRS patients with allergy were younger than those without.
- No significant clinicopathologic differences were found between EMCRS subgroups.
- EMCRS, as a group, exhibited more severe sinus disease than chronic rhinosinusitis.
Conclusions:
- Allergic fungal sinusitis (AFS) is not clinically distinct from other EMCRS subgroups.
- Eosinophilic mucus may indicate a more severe and distinct form of sinus disease.
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