title: Respiratory allergy to fungi in Barcelona, Spain: clinical aspects, diagnosis and specific treatment in a general allergy unit.
abstract: BACKGROUND
  The importance of hypersensitivity to fungal allergens is a relatively unknown and somewhat controversial subject.
  
  
  METHODS
  An open prospective study was carried out in just one centre to determine the clinical and epidemiological characteristics as well as the diagnostic usefulness of skin prick and conjunctiva provocation tests, associated with total and specific IgE determination in two groups of patients, one of which was monosensitised to fungi and the other of which had multiple sensitisations, including fungi.
  
  
  RESULTS
  Rhinitis, exclusive or associated with asthma, was the main consultation cause (88% in monosensitised patients). Severe asthma was rarely found. In the polysensitised group, 64% were simultaneously allergic to moulds and mites. Alternaria alternata was the most common sensitising fungus, although a considerable number of cases were associated with other species such as Cladosporium, Penicillium and/or Aspergillus. The skin prick test gave the highest sensitivity and specificity. In 67% of the cases, the specific IgE was found between classes 3 and 4. The conjunctival provocation test was an innocuous and highly useful method for verifying the diagnosis and determining the degree of clinical sensitisation. A large number of patients exclusively allergic to fungi received specific immunotherapy, and it was generally well tolerated.
  
  
  CONCLUSIONS
  This protocolised study shows the importance of Alternaria and other fungi sensitisations in rhinitis alone or associated with asthma. Combined diagnosis of prick test, specific IgE and conjunctiva provocation test is very useful for deciding specific immunotherapy.
authors.affiliation: Unitat d'Al·lèrgia i Immunologia, Clínica Teknon, Barcelona, Spain. jmtorresrod@gmail.com
authors.forename: Josep M
authors.initials: JM
authors.lastname: Torres-Rodríguez
authors.forename: Zeida
authors.initials: Z
authors.lastname: Pulido-Marrero
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Vera-García
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology; D000528:Alternaria / Q000276:immunology*; D000946:Antigens, Fungal / Q000276:immunology; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D006801:Humans; D007114:Immunization / Q000379:methods; D007073:Immunoglobulin E / Q000097:blood; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis* / Q000188:drug therapy*; D012882:Skin Tests; D013030:Spain; D055815:Young Adult
chemical_list: D000485:Allergens; D000946:Antigens, Fungal; D007073:Immunoglobulin E