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Allergic Aspergillus Rhinosinusitis

Allergic fungal rhinosinusitis (AFRS) is a unique variety of chronic polypoid rhinosinusitis usually in atopic individuals, characterized by presence of eosinophilic mucin and fungal hyphae in paranasal sinuses without invasion into surrounding mucosa. It has emerged as an important disease involvin...

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Autores principales: Chakrabarti, Arunaloke, Kaur, Harsimran
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5715928/
https://www.ncbi.nlm.nih.gov/pubmed/29376948
http://dx.doi.org/10.3390/jof2040032
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author Chakrabarti, Arunaloke
Kaur, Harsimran
author_facet Chakrabarti, Arunaloke
Kaur, Harsimran
author_sort Chakrabarti, Arunaloke
collection PubMed
description Allergic fungal rhinosinusitis (AFRS) is a unique variety of chronic polypoid rhinosinusitis usually in atopic individuals, characterized by presence of eosinophilic mucin and fungal hyphae in paranasal sinuses without invasion into surrounding mucosa. It has emerged as an important disease involving a large population across the world with geographic variation in incidence and epidemiology. The disease is surrounded by controversies regarding its definition and etiopathogenesis. A working group on “Fungal Sinusitis” under the International Society for Human and Animal Mycology (ISHAM) addressed some of those issues, but many questions remain unanswered. The descriptions of “eosinophilic fungal rhinosinusitis” (EFRS), “eosinophilic mucin rhinosinusitis” (EMRS) and mucosal invasion by hyphae in few patients have increased the problem to delineate the disease. Various hypotheses exist for etiopathogenesis of AFRS with considerable overlap, though recent extensive studies have made certain in depth understanding. The diagnosis of AFRS is a multi-disciplinary approach including the imaging, histopathology, mycology and immunological investigations. Though there is no uniform management protocol for AFRS, surgical clearing of the sinuses with steroid therapy are commonly practiced. The role of antifungal agents, leukotriene antagonists and immunomodulators is still questionable. The present review covers the controversies, recent advances in pathogenesis, diagnosis, and management of AFRS.
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spelling pubmed-57159282018-01-19 Allergic Aspergillus Rhinosinusitis Chakrabarti, Arunaloke Kaur, Harsimran J Fungi (Basel) Review Allergic fungal rhinosinusitis (AFRS) is a unique variety of chronic polypoid rhinosinusitis usually in atopic individuals, characterized by presence of eosinophilic mucin and fungal hyphae in paranasal sinuses without invasion into surrounding mucosa. It has emerged as an important disease involving a large population across the world with geographic variation in incidence and epidemiology. The disease is surrounded by controversies regarding its definition and etiopathogenesis. A working group on “Fungal Sinusitis” under the International Society for Human and Animal Mycology (ISHAM) addressed some of those issues, but many questions remain unanswered. The descriptions of “eosinophilic fungal rhinosinusitis” (EFRS), “eosinophilic mucin rhinosinusitis” (EMRS) and mucosal invasion by hyphae in few patients have increased the problem to delineate the disease. Various hypotheses exist for etiopathogenesis of AFRS with considerable overlap, though recent extensive studies have made certain in depth understanding. The diagnosis of AFRS is a multi-disciplinary approach including the imaging, histopathology, mycology and immunological investigations. Though there is no uniform management protocol for AFRS, surgical clearing of the sinuses with steroid therapy are commonly practiced. The role of antifungal agents, leukotriene antagonists and immunomodulators is still questionable. The present review covers the controversies, recent advances in pathogenesis, diagnosis, and management of AFRS. MDPI 2016-12-08 /pmc/articles/PMC5715928/ /pubmed/29376948 http://dx.doi.org/10.3390/jof2040032 Text en © 2016 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Chakrabarti, Arunaloke
Kaur, Harsimran
Allergic Aspergillus Rhinosinusitis
title Allergic Aspergillus Rhinosinusitis
title_full Allergic Aspergillus Rhinosinusitis
title_fullStr Allergic Aspergillus Rhinosinusitis
title_full_unstemmed Allergic Aspergillus Rhinosinusitis
title_short Allergic Aspergillus Rhinosinusitis
title_sort allergic aspergillus rhinosinusitis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5715928/
https://www.ncbi.nlm.nih.gov/pubmed/29376948
http://dx.doi.org/10.3390/jof2040032
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