Allergic fungal rhinosinusitis: pathophysiology, epidemiology, and diagnosis.
Allergic fungal rhinosinusitis (AFRS) is believed to have a cause similar to allergic bronchopulmonary aspergillosis (ABPA). Both are thought to be mediated by both type I (IgE) and type III (IgE-antigen immune complexes) Gell and Coombs reactions. ABPA patients also exhibit unique characteristics, such as HLA-DR2 or HLA-DR5 genotypes, and elevated suppressor T cell activity. While the pathophysiology of AFRS is similar histopathologically, similar immunologic studies have not been as well documented. Most cases of AFRS involve dematiaceous fungi, rather than Aspergillus. A suggested laboratory work-up for the disease is presented.
Houser
S M
SM
Department of Otolaryngology, Case Western Reserve University, Cleveland, Ohio, USA.
Corey
J P
JP
D006801:Humans; D009181:Mycoses; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D012720:Severity of Illness Index