Kawabori Shinichi, Watanabe Akihito, Osanai Hiroshi, Yoshizaki Tomoki, Taniguchi Masanobu
Department of Otolaryngology, Keiyukai Sapporo Hospital, Sapporo.
Nihon Jibiinkoka Gakkai Kaiho. 2002 Dec;105(12):1198-204. doi: 10.3950/jibiinkoka.105.1198.
Allergic fungal sinusitis is chronic and paranasal, related to fungal allergy. Many papers on allergic fungal sinusitis have been reported in the United State, and the incidence is 5% to 10% among patients with chronic paranasal sinusitis. Although cases of allergic fungal sinusitis have been reported in Japan, the incidence is unclear. We studied allergic fungal sinusitis in 40 consecutive patients--26 men and 14 women--undergoing endoscopic sinus surgery at Keiyukai Sapporo Hospital December 2000 to July 2001. We checked for allergic rhinitis and asthma, a history of surgery for nasal polyps and chronic sinusitis, the presence of nasal polyps, grading of sinusitis via computed tomography, nonspecific IgE and allergen-specific IgE for fungi in serum, eosinophilia in nasal smears, paranasal eosinophilic mucin, and histology and fungal culture of paranasal sinus mucus. None had typical allergic fungal sinusitis, but 1 had eosinophilic paranasal mucin, high IgE, and false-positive IgE for fungi. We studied clinical data and histology of fungi and paranasal mucosa in 9 cases with fungal maxillary sinusitis, but none had allergy or eosinophilic mucin. This suggested that few patients with allergic fungal sinusitis exist among those with chronic paranasal sinusitis.
变应性真菌性鼻窦炎是一种慢性鼻窦疾病，与真菌过敏有关。美国已有多篇关于变应性真菌性鼻窦炎的报道，在慢性鼻窦炎患者中的发病率为5%至10%。虽然日本也有变应性真菌性鼻窦炎的病例报道，但发病率尚不清楚。我们对2000年12月至2001年7月在札幌庆友会医院接受鼻内镜鼻窦手术的40例连续患者（26例男性和14例女性）进行了变应性真菌性鼻窦炎的研究。我们检查了变应性鼻炎和哮喘、鼻息肉和慢性鼻窦炎的手术史、鼻息肉的存在情况、通过计算机断层扫描对鼻窦炎的分级、血清中真菌的非特异性IgE和变应原特异性IgE、鼻涂片嗜酸性粒细胞增多、鼻窦嗜酸性黏液、以及鼻窦黏液的组织学和真菌培养。无一例有典型的变应性真菌性鼻窦炎，但有1例有嗜酸性鼻窦黏液、高IgE以及真菌IgE假阳性。我们研究了9例真菌性上颌窦炎患者的临床资料以及真菌和鼻窦黏膜的组织学情况，但均无过敏或嗜酸性黏液。这表明慢性鼻窦炎患者中变应性真菌性鼻窦炎患者很少。
