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- W2024111209 abstract "RATIONALE: Allergic fungal sinusitis (AFS) is a syndrome of chronic noninvasive fungal sinusitis resulting from a chronic hypersensitivity reaction to fungi in the paranasal sinuses. We followed a cohort of 25 patients with AFS and have observed four unusual complications. METHODS: With IRB approval, we reviewed medical records of all patients meeting published diagnostic criteria for AFS whom had been placed on long-term allergen immunotherapy to fungi. Individuals who experienced complications of AFS, beyond the usual chronic rhinosinusitis with polyps, were identified and contrasted to those patients without such complications. RESULTS: Four patients had serious complications associated with expansion of allergic mucin out of the paranasal sinuses. These included: 1)AFS with concomitant ABPA 2)AFS with expansion into the orbital fissure requiring orbital exoneration 3)AFS with expansion into brain stem requiring craniotomy 4)AFS with otitis media and tympanic membrane perforation. The mean IgE level for the 4 patients with complications was 1590 IU (range 65-16,000) versus 597 IU (50-2323) for the remaining 21 patients without severe complications. The mean number of sinus surgeries performed in the patients with complications was 3.5 versus 2.3. All 4 patients responded well to surgery, corticosteroids, and fungal allergen immunotherapy. CONCLUSION: AFS is a chronic disease resulting in the accumulation of large quantities of allergic mucin with the potential to expand outside the sinuses. To prevent complications, patients with this condition require long-term follow-up, longitudinal IgE determinations, surveillance rhinoscopy, and sinus imaging. Our results show that some individuals with AFS may present with major complications at the time of diagnosis." @default.
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- W2024111209 date "2010-02-01" @default.
- W2024111209 modified "2023-09-26" @default.
- W2024111209 title "Complications of Allergic Fungal Sinusitis" @default.
- W2024111209 doi "https://doi.org/10.1016/j.jaci.2009.12.398" @default.
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