title: Sublingual Immunotherapy for Allergic Fungal Sinusitis.
abstract: Allergic fungal sinusitis (AFS) is a condition that has an allergic basis caused by exposure to fungi in the sinonasal tract leading to chronic inflammation. Despite standard treatment modalities, which typically include surgery and medical management of allergies, patients still have a high rate of recurrence. Subcutaneous immunotherapy (SCIT) has been used as adjuvant treatment for AFS. Evidence exists to support the use of sublingual immunotherapy (SLIT) as a safe and efficacious method of treating allergies, but no studies have assessed the utility of SLIT in the management of allergic fungal sinusitis. A record review of cases of AFS that are currently or previously treated with sublingual immunotherapy from 2007 to 2011 was performed. Parameters of interest included serum IgE levels, changes in symptoms, Lund-McKay scores, decreased sensitization to fungal allergens associated with AFS, and serum IgE levels. Ten patients with diagnosed AFS were treated with SLIT. No adverse effects related to the use of SLIT therapy were identified. Decreases in subjective complaints, exam findings, Lund-McKay scores, and serum IgE levels were observed. Thus, sublingual immunotherapy appears to be a safe adjunct to the management of AFS that may improve patient outcomes.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Naval Medical Center Portsmouth, Portsmouth, VA, USA jonathan.m.melzer.mil@mail.mil.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Melzer
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Naval Medical Center Portsmouth, Portsmouth, VA, USA.
authors.forename: Brent R
authors.initials: BR
authors.lastname: Driskill
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Naval Medical Center Portsmouth, Portsmouth, VA, USA.
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Clenney
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Naval Medical Center Portsmouth, Portsmouth, VA, USA.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Gessler
mesh_terms: D000328:Adult; D000485:Allergens / Q000008:administration & dosage*; D002908:Chronic Disease; D018876:Environmental Illness / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005658:Fungi / Q000276:immunology*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008501:Medical Records, Problem-Oriented; D055502:Secondary Prevention / Q000379:methods; D012852:Sinusitis / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D063729:Sublingual Immunotherapy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000485:Allergens; D007073:Immunoglobulin E
keywords: AFS; SCIT; SLIT; allergic; allergy; fungal; immunotherapy; rhinosinusitis; sinusitis; sublingual