PMID- 24364238
OWN - NLM
STAT- MEDLINE
DCOM- 20151027
LR  - 20190918
IS  - 0370-8179 (Print)
IS  - 0370-8179 (Linking)
VI  - 141
IP  - 9-10
DP  - 2013 Sep-Oct
TI  - [Allergic fungal sinusitis--new aspects of clinical features, laboratory 
      diagnosis and therapy].
PG  - 698-704
AB  - Allergic fungal sinusitis (AFS) is a chronic non-invasive disease. Hypersensitive 
      immune response is usually initiated by allergens of filamentous fungi 
      Aspergillus, Penicillium, Cladosporium, Fusarium, Bipolaris, Curvularia and 
      Alternaria. AFS is a clinical and immune analogue of the allergic 
      bronchopulmonary aspergillosis (ABPA) as the sinus exudate resembles that of the 
      bronchoalveolar lavage (BAL) in ABPA. Patients with AFS are usually 
      immunocompetent, atopic and males. The most common symptoms are headache, 
      fullness in the paranasal sinuses, and difficult breathing through the nose. 
      Clinically, there is a chronic mucosal inflammation and histopathologic finding 
      shows allergic mucin and eosinophils. Specific staining methods, Gomori's 
      Methenamine Silver (GMS) or periodic acid-Schiff (PAS), are used for microscopic 
      visualisation of hyphae, which are, in addition to the isolated fungi, most 
      reliable evidence of AFS. Computerized tomography (CT) of paranasal sinuses shows 
      the areas of hyperdensity. In cases where AFS is complicated by the erosion of 
      bone tissue, discontinuation of the sinus bone wall can be seen. Significant 
      laboratory finding, which correlate highly with the AFS, are high immunoglobulin 
      E (IgE) antibodies specific for fungi, detected by the skin prick test or in 
      serum. Treatment is often surgical, and after removal of the allergic mucin, 
      therapy involves oral and nasal corticosteroids, immunotherapy and locally 
      applied antimycotics (with verified fungal etiology). During treatment, the 
      total/specific IgE is monitored--concentration increases with the development of 
      AFS, and decreases during the improvement process. Knowledge of the 
      pathophysiological mechanisms of AFS is scarce, and represents the focus of 
      further research in order to define an optimal diagnostic and therapeutic 
      approach.
FAU - Arsenijevic, Valentina Arsic
AU  - Arsenijevic VA
AD  - National Medical Mycology Reference Laboratory, Institute of Microbiology and 
      Immunology, School of Medicine, University of Belgrade, Belgrade, Serbia. 
      mikomedlab@yahoo.com
FAU - Barac, Aleksandra
AU  - Barac A
AD  - National Medical Mycology Reference Laboratory, Institute of Microbiology and 
      Immunology, School of Medicine, University of Belgrade, Belgrade, Serbia.
FAU - Pekmezovic, Marina
AU  - Pekmezovic M
AD  - Faculty of Biology, University of Belgrade, Belgrade, Serbia.
FAU - Stosovic, Rajica
AU  - Stosovic R
AD  - Institute of Allergology and Immunology, Clinical Center of Serbia, Belgrade, 
      Serbia.
FAU - Pender, Ivica
AU  - Pender I
AD  - Institute of Otorhinolaryngology, Clinical Center of Serbia, Belgrade, Serbia.
LA  - srp
PT  - Journal Article
PT  - Review
PL  - Serbia
TA  - Srp Arh Celok Lek
JT  - Srpski arhiv za celokupno lekarstvo
JID - 0027440
SB  - IM
MH  - Chronic Disease
MH  - Female
MH  - Humans
MH  - Male
MH  - Mycoses/complications/*diagnosis/*therapy
MH  - Respiratory Hypersensitivity/*diagnosis/etiology/*therapy
MH  - Sinusitis/*diagnosis/etiology/*therapy
EDAT- 2013/12/25 06:00
MHDA- 2015/10/28 06:00
CRDT- 2013/12/25 06:00
PHST- 2013/12/25 06:00 [entrez]
PHST- 2013/12/25 06:00 [pubmed]
PHST- 2015/10/28 06:00 [medline]
AID - 10.2298/sarh1310698a [doi]
PST - ppublish
SO  - Srp Arh Celok Lek. 2013 Sep-Oct;141(9-10):698-704. doi: 10.2298/sarh1310698a.