Aeumjaturapat Songklot, Saengpanich Supinda, Isipradit Permsarp, Keelawat Somboon
Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
J Med Assoc Thai. 2003 May;86(5):420-4.
Many terms related to allergic fungal rhinosinusitis (AFRS) such as eosinophilic mucin rhinosinusitis (EMRS), eosinophilic fungal rhinosinusitis (EFRS), and AFRS-like syndrome have been proposed. The authors define EMRS as patients with rhinosinusitis who demonstrate eosinophilic mucin on histopathological examination. EMRS patients who demonstrate fungal hyphae within the mucin are diagnosed as having EFRS and those who cannot demonstrate fungal hyphae within the mucin are diagnosed as having EFRS-like syndrome. EFRS patients who demonstrate an allergic response to the fungi are diagnosed as having AFRS and those who cannot demonstrate any allergic responses to the fungi are diagnosed as having non-allergic fungal rhinosinusitis (NAFRS). In the United States, the prevalence of AFRS in chronic rhinosinusitis patients who require surgery is 5-10 per cent. However, the prevalence of AFRS in Thailand is not known because AFRS has never been reported and studied in Thailand. This study shows the clinical and pathological entities of patients with EMRS in King Chulalongkorn Memorial Hospital from July 2001 to July 2002. From a total of two hundred and fourteen rhinosinusitis patients who required surgery, six were diagnosed as having EMRS. Two of six EMRS patients were diagnosed as having EFRS (both of them were also diagnosed as having AFRS) and four patients were diagnosed as having EFRS-like syndrome. In this study, the prevalence of AFRS is much less than in the United States because of the limited understanding of this disease, the lack of commercially available antigens for dematiaceous fungi, and the lack of awareness and knowledge of pathologists to diagnose eosinophilic mucin and fungi within the mucin. The terms related to AFRS are also discussed in this study.
已经提出了许多与变应性真菌性鼻窦炎（AFRS）相关的术语，如嗜酸性黏液性鼻窦炎（EMRS）、嗜酸性真菌性鼻窦炎（EFRS）和AFRS样综合征。作者将EMRS定义为在组织病理学检查中显示嗜酸性黏液的鼻窦炎患者。在黏液中显示真菌菌丝的EMRS患者被诊断为患有EFRS，而在黏液中未显示真菌菌丝的患者被诊断为患有EFRS样综合征。对真菌表现出过敏反应的EFRS患者被诊断为患有AFRS，而对真菌未表现出任何过敏反应的患者被诊断为患有非变应性真菌性鼻窦炎（NAFRS）。在美国，需要手术的慢性鼻窦炎患者中AFRS的患病率为5%至10%。然而，泰国AFRS的患病率尚不清楚，因为泰国从未报道和研究过AFRS。本研究展示了2001年7月至2002年7月朱拉隆功国王纪念医院EMRS患者的临床和病理情况。在总共214名需要手术的鼻窦炎患者中，有6名被诊断为患有EMRS。6名EMRS患者中有2名被诊断为患有EFRS（他们两人也被诊断为患有AFRS），4名患者被诊断为患有EFRS样综合征。在本研究中，由于对这种疾病的了解有限、缺乏用于暗色真菌的商用抗原以及病理学家对诊断嗜酸性黏液和黏液内真菌的认识和知识不足，AFRS的患病率远低于美国。本研究还讨论了与AFRS相关的术语。
