Sinobronchial Allergic Mycosis

Monday, September 22nd, 2014 No Commented
Categorized Under: Allergies

The five convincing case reports of patients with concomitant AFS and ABPM reviewed here clearly demonstrate that these diseases occur together and constitute a syndrome of sinobronchial allergic mycosis (SAM). A classification of sinopulmonary syndromes is presented in Table 2. Patients with SAM are atopic individuals who have asthma, rhinosinusitis, and high levels of total and fungal-specific ige.

The common histopathologic findings of eosinophilic mucin with layers of cellular debris and scant degenerating hyphae in both the upper and lower airways support the conclusion that these are similar hypersensitivity reactions to fungal elements occurring at different locations in the same airway.

Other data also suggest that the pathogenesis of these diseases is similar. In a review of the his topathologic features of AFS, Kahn et al 24 noted the histopathologic similarities between ABPM and AFS. There is evidence for the active contribution of both eosinophil-derived and neutrophil derived products, including eosinophil major basic protein and neutrophil elastase, like that seen in late-phase cutaneous reactions. Australia viagra information

Their findings support earlier suggestions that ubiquitous fungal spores induce a robust, IgE-mediated inflammatory response that induces the viscous mucous secretions these patients experience. Eosinophil derived and neutrophil-derived toxic proteins have the capacity to induce tissue destruction leading to the layers of eosinophil and epithelial cellular debris that are component parts of the allergic mucin. The mucin obstructs the airways leading to ongoing infection. Since the presence of only small quantities of fungal hyphae in the airway is necessary to initiate the eosinophilic inflammatory process associated with the disease, obstruction to normal drainage of the airway seen in both asthma and chronic sinusitis could be a common feature predisposing an individual to the development of these conditions.