title: Serum IgE Levels: An Effective Diagnostic Tool for Evaluation and Monitoring of Orbital Fungal Granuloma.
abstract: OBJECTIVE
  To determine the changes in IgE levels in diagnosis and postoperative monitoring of orbital fungal granuloma.
  
  
  METHODS
  Descriptive analytical study.
  
  
  METHODS
  Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan, from July 2012 to June 2013.
  
  
  METHODS
  Cases with clinically high index of suspicion for orbital fungal granuloma and 50 healthy volunteers were inducted as control subjects. Patients with recurrent cases of orbital fungal granuloma, previous orbital surgery, and those with very low clinical suspicion of fungal granuloma were excluded. Total serum IgE level (IU/ml), eosinophil counts and skin prick test were performed in all subjects. Independent t-test was used for comparison of healthy volunteers and patients with biopsy proven orbital fungal granuloma. Repeated measures ANOVA was used for comparing the preoperative and postoperative total serum IgE level of patients with biopsy proven fungal granuloma.
  
  
  RESULTS
  The mean total serum IgE level for the healthy volunteers was 208.82 ±41.43 IU/ml. The mean pre-operative IgE value of histologically confirmed cases of fungal granuloma was 1613.72 ±282.83 IU/ml. The total serum IgE level gradually declined after surgery and anti-fungal treatment. The mean serum IgE level 3, 6 and 9 months postoperatively were 1039.48 ±308.40, 568.77 ±162.01 and 224.92 ±51.55 IU/ml respectively. These tests showed that the drop in IgE level in cases of fungal granuloma with treatment was statistically significant (p < 0.001).
  
  
  CONCLUSIONS
  Total serum IgE level can be used as a reliable diagnostic and postoperative monitoring tool in orbital fungal granuloma.
authors.affiliation: Department of Orbit and Oculoplastics, Al-Shifa Trust Eye Hospital, Jhelum Road, Rawalpindi.
authors.forename: Tayyab
authors.initials: T
authors.lastname: Afghani
authors.affiliation: Department of Orbit and Oculoplastics, Al-Shifa Trust Eye Hospital, Jhelum Road, Rawalpindi.
authors.forename: Hassan
authors.initials: H
authors.lastname: Mansoor
authors.affiliation: Department of Orbit and Oculoplastics, Al-Shifa Trust Eye Hospital, Jhelum Road, Rawalpindi.
authors.forename: Abdullah Naeem
authors.initials: AN
authors.lastname: Syed
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D015821:Eye Infections, Fungal / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006099:Granuloma / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D009916:Orbital Diseases / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D012882:Skin Tests; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D015415:Biomarkers; D007073:Immunoglobulin E