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Absorption of Nasal and Bronchial Fluids: Precision Sampling of the Human Respiratory Mucosa and Laboratory Processing of Samples
Published on: January 21, 2018
Allergic fungal sinusitis: the Mayo Clinic experience
D T Cody1, H B Neel, J A Ferreiro
1Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN 55905.
The Laryngoscope
|September 1, 1994
Summary
Diagnosing allergic fungal sinusitis (AFS) is challenging. This study reviews diagnostic criteria, the role of immunoglobulin E (IgE) and G (IgG), and clinical features, finding Dematiaceous fungi predominant in AFS cases.
Area of Science:
- Otolaryngology
- Allergy and Immunology
- Mycology
Background:
- Allergic fungal sinusitis (AFS) diagnosis is complex due to non-specific clinical presentations.
- Establishing definitive diagnostic criteria for AFS remains a clinical challenge.
- Understanding the role of immunoglobulin E (IgE) and G (IgG) is crucial for AFS diagnosis.
Purpose of the Study:
- To define current diagnostic criteria for Allergic Fungal Sinusitis (AFS).
- To elucidate the role of total and specific immunoglobulin E (IgE) and immunoglobulin G (IgG) in AFS.
- To review the clinical features and prevalence of AFS.
Main Methods:
- Retrospective review of 51 cases in 44 patients with characteristic allergic mucin.
- Application of rigid diagnostic criteria for AFS and classification of AFS-like syndromes.
- Analysis of fungal cultures, IgE/IgG levels, and clinical comorbidities.
Main Results:
- Thirty-one cases met strict AFS criteria; 20 were classified as AFS-like.
- The prevalence of strictly defined AFS was 4.0%, with Dematiaceous fungi being predominant.
- Common comorbidities included nasal polyps (100%), asthma (54%), aspirin sensitivity (27%), eosinophilia (65%), and elevated total IgE (69%).
Conclusions:
- Rigid diagnostic criteria are essential for accurately identifying AFS.
- Immunoglobulin levels (IgE, IgG) and specific fungal sensitization play a role in AFS.
- AFS often co-exists with asthma, aspirin sensitivity, and eosinophilia, highlighting its allergic basis.
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