The Relationship Between Systemic Steroid Therapy and the Level of Serum Ige in Allergic Fungal Rhinosinusitis

Abstract

Background: Adequate study of allergic fungal rhinosinusitis (AFRS) helped better understanding of the nature of the disease. It involves immediate hypersensitivity to fungus present in the nose and sinuses. This involves immunoglobulin E. Therefore the presence of serum IgE indicates the presence of the allergic reaction.The objective is to evaluate the relationship between systemic steroid therapy and the level of serum IgE in allergic fungal rhinosinusitis indicating adequate therapy. This is a prospective study. Subjects and Methods: Forty patients diagnosed as allergic fungal sinusitis were randomly divided into two equal groups: group A was given postoperative systemic steroids and local steroids, while group B was not given systemic steroids (local steroids only). The patients were followed up for three and six months by testing IgE levels in blood. Results: The total number of patients who had more than 10% increase in serum IgE after 6 months post-operative was 18 patients. Six of them were from group A (Systemic steroids) and 12 were from group B (Local steroids). Conclusion:There was a strong relation between systemic steroid therapy and the level of serum IgE. Thus, AFS should be treated by systemic steroids for a prolonged period after adequate clearance of the sinuses. Patients should be followed up at close intervals post-operative using serum Ig E as it can indicate increased fungal load and the need for further treatment.

An investigation on non-invasive fungal sinusitis; Molecular identification of etiologic agents

“…Postoperative steroids’ therapy is usually recommended to decrease allergy, inflammation, and sensitization for long-term control, but recurrences are usual. [ 15 16 20 ] All patients are usually treated with intranasal steroid sprays, similar to the patients of this investigation. AFS is treated much differently than IFS and must be marked with discerning histopathologic features of IFS that is inflammatory cells within the tissue instead of free-floating in mucin, presence of fungal elements within the vascular spaces and tissues.…”