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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...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2016
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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. |
format | Online Article Text |
id | pubmed-5715928 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT chakrabartiarunaloke allergicaspergillusrhinosinusitis AT kaurharsimran allergicaspergillusrhinosinusitis |