Stewart Alexander E, Hunsaker Darrell H
Department of Otolaryngology, Naval Medical Center, San Diego, CA 92134-1005, USA.
Otolaryngol Head Neck Surg. 2002 Oct;127(4):324-32. doi: 10.1067/mhn.2002.126801.
Our study goal was to study fungus-specific immunoglobulins G (sIgG) and E (sIgE) in polypoid rhinosinusitis with and without evidence of allergic fungal rhinosinusitis (AFS).
A prospective analysis was conducted of fungal sIgG and sIgE using a 9-mold RAST panel in 13 AFS, 11 AFS-like, and 27 non-AFS polypoid rhinosinusitis patients. Nonpolyp controls included 17 volunteers with allergic rhinitis and 11 with no atopic history.
All groups had elevated fungal sIgG levels. Polyps, increasing polyp severity, and AFS were associated with elevated fungal sIgG to a greater number of molds. The AFS group had sIgE elevations (>or=class II) to an average of 5 molds versus only 0.1 in the non-AFS polyp group. Total IgE was 971 U/mL versus 64 U/mL, respectively.
Multiple elevations of fungal sIgE are adequate diagnostic evidence of these fungi when fungal cultures and histologic examinations are negative in diagnosing AFS. The significance of increased fungal sIgG remains unclear.
Early recognition of AFS may be facilitated by screening polypoid rhinosinusitis patients with total serum IgE and RAST testing.
我们的研究目标是研究伴有或不伴有变应性真菌性鼻窦炎（AFS）证据的息肉样鼻窦炎患者的真菌特异性免疫球蛋白G（sIgG）和E（sIgE）。
采用9种霉菌RAST检测板对13例AFS患者、11例AFS样患者和27例非AFS息肉样鼻窦炎患者进行真菌sIgG和sIgE的前瞻性分析。非息肉对照组包括17例变应性鼻炎志愿者和11例无特应性病史者。
所有组的真菌sIgG水平均升高。息肉、息肉严重程度增加以及AFS与更多霉菌的真菌sIgG升高相关。AFS组sIgE升高（≥II级）至平均5种霉菌，而非AFS息肉组仅为0.1种。总IgE分别为971 U/mL和64 U/mL。
当真菌培养和组织学检查在诊断AFS时为阴性时，真菌sIgE的多次升高是这些真菌的充分诊断证据。真菌sIgG升高的意义仍不清楚。
通过对息肉样鼻窦炎患者进行血清总IgE筛查和RAST检测，可能有助于早期识别AFS。
