EVIDENCE OF IGE-MEDIATED HYPERSENSITIVITY IN ALLERGIC FUNGAL SINUSITIS

Despite documentation of specific immunologic hypersensitivity in a fe w case reports, controversy continues as to the role of allergy versus true infection in the clinical entity of allergic fungal sinusitis (A FS). Using a modified radioallergosorbent test (RAST) to multiple fung al antigens, 16 patients meeting the histologic criteria of AFS and wi th positive fungal cultures were compared to 5 control patients with s imilar preoperative clinical findings but without histologic or cultur e evidence of AFS. All patients were immunocompetent and none demonstr ated histologic evidence of tissue invasion. All AFS patients were RAS T-positive to at least one fungal antigen in the family of their cultu red organism with positive defined as class 2 or greater. No control p atient was RAST-positive to either dematiaceous or Aspergillus fungal antigens. Thus, modified RAST testing can aid in the routine clinical diagnosis of AFS, and it provides further serologic evidence for a typ e I hypersensitivity in the pathogenesis of AFS.