scholarly journals Evaluation of Diagnostic Criteria for AFRS: A Hospital Based Study

2017 ◽  
Vol 25 (3) ◽  
pp. 130-135
Author(s):  
Krishna V Chaitanya ◽  
Lakshmi C Kalavathi
Keyword(s):  
Skin Prick Test ◽  
Ct Scan ◽  
Diagnostic Criteria ◽  
Paranasal Sinus ◽  
Eosinophil Count ◽  
Total Serum ◽  
Prick Test ◽  
Absolute Eosinophil Count ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis

Introduction Bent and Kuhn criteria are the most commonly accepted diagnostic criteria for diagnosis of Allergic Fungal Rhinosinusitis. Other diagnostic criteria for the diagnosis of Allergic Fungal Rhinosinusitis include unilateral nasal disease, Charcot Leyden crystals, bony erosions which form the minor criteria in the diagnosis of Allergic Fungal Rhinosinusitis. Clinical and Laboratory features in Allergic fungal rhinosinusitis are variable. These variations in the diagnostic criteria in the diagnosis of Allergic Fungal Rhinosinusitis have been analysed in the present study. Materials and Methods Prospective study was performed on group of 46 patients of Allergic fungal Rhinosinusitis presenting in the Otorhinolaryngology OPD with symptoms of Allergic fungal rhinosinusitis as diagnosed and persisting for more than 3 months during September 2009 to August 2010. Results Absolute eosinophil count was elevated in 80.43%, total serum IgE elevated in 69.67%, skin prick test was positive in 63.05% of patients. CT scan revealed that most common paranasal sinus involved is ethmoid sinus as seen in 73.91% cases., Sphenoid sinus was least involved as seen in 17.40% cases. More than one paranasal sinus were involved in 65.21% of the cases.,Complete opacification of all sinuses with calcified deposits were seen in 4.76% cases. Mucosal thickening was seen bilaterally in 73.91% of the patients and bony erosion was noted in 6.52% of patients. Histopathology of nasal smears revealed Eosinophilia in 80.43% of patients. Inflammatory Charcot Leyden crystals were found in 15.21% of the patients45.65% showed goblet cell hyperplasia . Other types of inflammatory cells were seen in 56.52%of the study population and 23.91% patients showed positive fungal hyphae. Discussion The significance of absolute eosinophil count, skin prick test, histopathology, CT Scan features and nasal smear cytology have been discussed along with review of literature. Conclusion Although management of Allergic Fungal Rhinosinusitis has advanced tremendously with better understanding of underlying pathogenesis, diagnostic strategies are still far from clear and are still emerging. Lot of research work has to be carried out regarding relevant diagnostic criteria for the disease.

scholarly journals Study of causal aeroallergens in allergic rhinitis

2019 ◽  
Vol 5 (4) ◽  
pp. 916
Author(s):  
Divya Aggarwal ◽  
Abhilash S. ◽  
Sunil Kapur ◽  
Divya Gupta
Keyword(s):  
Allergic Rhinitis ◽  
Skin Prick Test ◽  
Symptom Score ◽  
Eosinophil Count ◽  
Severe Disease ◽  
Nasal Symptom ◽  
Total Serum ◽  
Serum Ige ◽  
Prick Test ◽  
Absolute Eosinophil Count

<p class="abstract"><strong>Background:</strong> The diagnosis of allergic rhinitis requires a detailed history, thorough clinical examination and identification of aeroallergens by skin prick test. The diagnosis cannot be confirmed on the basis of symptoms alone because both allergic and non-allergic rhinitis can present with similar symptoms. The present study was undertaken to identify the common aeroallergens causing allergic rhinitis and to find any relationship of the severity of patient’s symptoms with raised levels of absolute eosinophil count, percentage of eosinophils in the peripheral blood and total serum IgE.</p><p class="abstract"><strong>Methods:</strong> It is cross sectional study was conducted among 100 patients including both the genders attending out-patient department of ENT. The patients were divided into mild, moderate and severe disease categories based on nasal symptom score (NSS) which was calculated taking into account the severity of four symptoms namely sneezing, watery rhinorrhoea, itching sensation in nose and nasal obstruction.  </p><p class="abstract"><strong>Results:</strong> 76% of patients had moderate nasal symptom score and 42% had symptoms of allergic rhinitis for less than 3 years. The prevalence of skin prick test was strongly positive for pollens (46.19%), followed by dust (16.4%), dust mites (15.7%), fungus (9.7%), insects (9.24%) and epithelia (2.77%). But, among 68 aeroallergens, most common offending allergen was D-farinae (30%). There was no significant relationship found to exist between Eosinophilia, Absolute eosinophil count and serum IgE level with that of nasal symptom score.</p><p class="abstract"><strong>Conclusions:</strong> Skin prick test is the gold standard investigation of choice for definitive diagnosis of allergic rhinitis.</p><p class="abstract"> </p>

Evaluation of the Role of Immunotherapy in Allergic Fungal Rhinosinusitis

2021 ◽  
Vol 30 (3) ◽  
pp. 111-117
Author(s):  
Ghada A. Mokhtar ◽  
Sylvia W. Roman ◽  
Aya M. Elgendy ◽  
Marian A. Gerges ◽  
Alsayed Abdulmageed ◽  
...  
Keyword(s):  
Endoscopic Examination ◽  
Type I ◽  
Fungal Culture ◽  
Total Ige ◽  
Prick Test ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Fungal Allergens ◽  
Type I Hypersensitivity

Background: Allergic fungal rhinosinusitis (AFRS) is a distinct form of chronic rhinosinusitis. Type I hypersensitivity to inhaled fungal allergens has been implicated as key pathogenesis. Immunotherapy as one of the therapeutic options is still controversial. Objective: to evaluate the role of immunotherapy in the management of AFRS patients not responding to medical treatment 3 months following endoscopic surgery. Methodology: A total of 35 patients diagnosed as resistant AFRS were included in this prospective study. Patients were diagnosed following clinical, radiological, and endoscopic examination of nose and paranasal sinuses. Specimens were collected during endoscopy and subjected to microscopic examination and fungal culture. Skin prick test and assessment of total IgE level were performed for all patients. Sublingual immunotherapy (SLIT) was initiated for all patients for 6 months. Clinical efficacy of SLIT was assessed using the 20-item sino-nasal outcome test (SNOT-20) score. Results: Aspergillus spp. was the most frequent fungus isolated (74.3%) from patients. All patients were sensitized to mixed fungi. Elevated total IgE (> 100 IU/mL) was found in all patients with 40% of them had peripheral eosinophilia. A significant improvement (p < 0.001) was recorded in the SNOT-20 score of examined patients recording a mean of 1.2 ± 0.3, 6 months after SLIT compared to 1.93 ± 0.44 before immunotherapy initiation. Conclusion: Immunotherapy appears to be a good adjunctive therapy for the management of resistant cases of AFRS.

scholarly journals The investigation of allergic skin diseases susceptibility

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Prajwal Pandey ◽  
◽  
Wei Min Shi ◽  
Samir Shrestha ◽  
◽  
...  
Keyword(s):  
Skin Prick Test ◽  
Skin Diseases ◽  
Total Serum ◽  
Sample Population ◽  
Serum Ige ◽  
Prick Test ◽  
Clinical Allergy ◽  
Allergic Skin ◽  
One Year ◽  
Allergic Disorders

Background: Studies from around the world show that the prevalence and incidence of sensitization to allergens are higher in urban settings. Skin Prick Test (SPT) is being used more frequently now to investigate specific allergen sensitivity along with serum IgE level. Objective: The objective of our study was to evaluate the prevalence of sub-clinical allergy susceptibility and to see association with gender, season, age, urticaria, eczema, dermatitis and total serum IgE. Method and methodology: Eight hundred and ninety-two patients referred by dermatologist to rule out allergic sensitizations underwent SPT within one year. We calculated susceptible group and evaluated its ability to predict diseases like urticaria, eczema and non-specific dermatitis in general population. Result: The antigens that had the highest prevalence throughout the year were Mould II (32.38%) and Dermatophagoides farina (33.78%). The susceptibility to allergen was affected by season and age, however was not affected by gender. The predictability was highly statistically significant for Urticaria, Eczema and Non-specific Dermatitis. Conclusion: We conclude that the allergen susceptibility is high and is significantly correlated to the prevalence of allergic disorders in the sample population of a modern city like Shanghai. The susceptibility to allergen is affected by season and age. Keywords: skin prick test; total serum IgE; sub-clinical allergy susceptibility.

scholarly journals Soy Skin Prick Test in Patients with Physician-Diagnosed Atopic Disorders

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S M Reda ◽  
N M Radwan ◽  
H R Abdelghany
Keyword(s):  
Allergic Rhinitis ◽  
Skin Prick Test ◽  
Soy Protein ◽  
Total Serum ◽  
Positive Skin Prick Test ◽  
Positive Skin ◽  
Female Ratio ◽  
Serum Ige ◽  
Prick Test ◽  
Protein Sensitization

Abstract Background Soy protein is an important component of soybeans and is one the 8 most significant food allergens. Yet, the prevalence of soy allergy in the pediatric population is not well defined. Objectives To evaluate the incidence of IgE mediated soy protein sensitization among children with clinical manifestation of atopic disorders by the use of skin prick test (SPT) for soy protein. Methods Two hundred patients with atopic manifestations attending the Pediatric Allergy and Immunology Clinic at the Pediatric Department of Ain shams University, were recruited between January 2017 till January 2018. They were subjected to SPT to soy protein, measurement of total serum IgE and eosinophilic count in the peripheral blood. Results Of the 200 patients, 108 (54%) were males and 92 (46%) were females with a male to female ratio of 1.17:1. Their ages ranged between 2 years and 15 years (mean±SD; 6.0±33.3 years). Seven patients (3.5%) had positive skin prick test to soy protein. The mean value for the absolute eosinophilic count was 0.4x109/L. The median for the total serum IgE level was 50 IU/L. According to age, the highest percentage of soy protein sensitivity was elicited among patients less than 3 years (57.14%), followed by those between 3 to 6 years (28.5%) and those between 6 and 15 years (14.28%). A positive family history of atopy was recorded in 122 (61%) of all cases. In terms of gender, incidence of soya sensitivity was higher among males than females but with no statistical difference. Although the most common allergic manifestations of all studied patients were respiratory (83%), and atopic dermatitis (22.5%), yet positive SPT to soy proteins was elicited in 43% in allergic rhinitis cases, in 29% of asthma patients, in 14% of patients with combined asthma and allergic rhinitis, and 14.3% of patients having eczema. Conclusion Soy protein sensitization is not uncommon in children especially in those with atopic manifestations. Large scale studies are needed to evaluate the actual incidence of soy protein hypersensitivity in children.

scholarly journals Radiologic Appearances in Fungal Rhinosinusitis

2009 ◽  
Vol 1 (1) ◽  
pp. 15-24 ◽  
Keyword(s):  
Ct Scan ◽  
Radiological Diagnosis ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Early Phases ◽  
Invasive Fungal Rhinosinusitis

Abstract Radiological diagnosis forms an important tool in the armamentarium to diagnose and classify fungal rhinosinusitis. However, many times, the appearances may be deceptive; while on one hand in Allergic Fungal Rhinosinusitis the appearance is classical and considered one of the clinchers in the diagnosis of the condition, in invasive fungal rhinosinusitis (especially in the early phases), the appearances may range from a nonspecific sinusitis to even a ‘apparently normal’ scan! CT scan as well as MRI may at times complement each other, in order to aid the clinician arrive at a diagnosis. Nevertheless, despite the best radiologic modalities, a clinicoradiological correlation is a must to accurately diagnose this often deceptive condition called fungal rhinosinusitis.

scholarly journals ALLERGEN COMPONENT TESTING – A NEW ERA IN DIAGNOSTICS OF PATIENTS WITH POLLEN ALLERGY

2019 ◽  
Vol 72 (3) ◽  
pp. 391-394
Author(s):  
Svitlana Zubchenko ◽  
Olena Sharikadze ◽  
Stepan Maruniak
Keyword(s):  
Skin Prick Test ◽  
Allergen Immunotherapy ◽  
Pollen Allergy ◽  
Developed Countries ◽  
Test System ◽  
Assay Method ◽  
Total Serum ◽  
Allergen Specific Immunotherapy ◽  
Prick Test ◽  
Component Testing

Introduction: Pollen allergy, also called hay fever or pollinosis, is referred to the most widespread allergic diseases. According to different sources, from 5 to 34% of the population in developed countries are likely to suffer from this condition. Moreover, the majority of patients are young people of working age The aim: To demonstrate a practical decision of the choice of effective treatment tactics based on component testing in patients with pollen allergy. Materials and methods: 126 рatients with allergic rhinitis / conjunctivitis were randomly selected according to their primary visit during the first week in August of the current year. Among them, 53 (42.0%) female and 73 (58.0%) male, aged 22-47 years. General laboratory and instrumental investigations, skin prick test with allergen extracts (Diater, Spain), measurement of total serum and specific IgE by immunoenzymatic assay method using test system “Euroimmun” were performed. Immunofluorescent method ImmunoCap (Thermo Scientific, Uppsala, Swiss) was used to detect specific components of allergens. The material of investigation was blood serum. Results: According to the results of skin prick-test, 50% of patients could receive allergen immunotherapy with two different extracts of allergens “Mixture of Weeds” and “Mixture of Grass”. On molecular investigations, it was detected that this combination was not suitable for any patient (20% of individuals had genuine sensitization to allergens of grass pollen, including a marker of cross-reactive molecules, 30% of individuals were sensitized with genuine allergens of Artemisia and/or ambrosia). Conclusions: Based on skin prick-test and molecular diagnostics, the doctor makes a completely different decision on the choice of extracts for allergen immunotherapy conduction. Component determination of a sensitized profile and high sensitivity of this method enables to reveal a genuine protein, which is the primary cause of allergy occurrence and administer etiotropic allergen-specific immunotherapy with the allergen, to which sensitization was detected.

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