Metrika članka

  • citati u SCindeksu: [1]
  • citati u CrossRef-u:0
  • citati u Google Scholaru:[=>]
  • posete u poslednjih 30 dana:21
  • preuzimanja u poslednjih 30 dana:8
članak: 1 od 24  
Srpski arhiv za celokupno lekarstvo
2013, vol. 141, br. 9-10, str. 698-704
jezik rada: srpski
vrsta rada: prikaz
doi:10.2298/SARH1310698A


Alergijski fungalni sinuzitis - novi aspekti kliničkih odlika, laboratorijske dijagnoze i lečenja
aUniverzitet u Beogradu, Medicinski fakultet, Institut za mikrobiologiju i imunologiju
bUniverzitet u Beogradu, Biološki fakultet
cKlinički centar Srbije, Institut za alergologiju i imunologiju, Beograd
dKlinički centar Srbije, Institut za otorinolaringologiju, Beograd + Univerzitet Privredna akademija u Novom Sadu, Stomatološki fakultet, Pančevo

e-adresa: mikomedlab@yahoo.com

Projekat

Značaj dokazivanja ranih laboratorijskih biomarkera za ishod invazivnih gljivičnih infekcija kod nas (MPNTR - 175034)

Sažetak

Alergijski fungalni sinuzitis (AFS) je hronično oboljenje, primarno neinvazivne prirode. Hipersenzitivni imunski odgovor je najčešće pokrenut alergenima filamentoznih gljivica iz rodova: Aspergillus, Penicillium, Cladosporium, Fusarium, Bipolaris, Curvularia i Alternaria. AFS je klinički i imunološki analog alergijskoj bronhopulmonalnoj aspergilozi (ABPA), a nalaz gljivica u sinusnom eksudatu je sličan nalazu u bronhoalveolarnom lavatu kod ABPA. Pacijenti sa AFS su uglavnom imunokompetentne osobe, atopijske konstitucije, muškog pola, dok su najčešći simptomi glavobolja, osećaj punoće u paranazalnim sinusima i otežano disanje kroz nos. Klinički, sluznicu sinusa odlikuje hronično zapaljenje, a patohistološkim bojenjem se uočavaju alergijski mucin i brojni eozinofili. Specijalizovanim metodama bojenja za gljivice, Grocott-Gomori metenamin srebro (GMS) ili periodic acid-Schiff (PAS), mikroskopski se uočavaju hife, što je, pored izolacije gljivica (mikološka kultura), najsigurniji dokaz AFS. Na nalazu kompjuterizovane tomografije (CT) paranazalnih sinusa može se uočiti zona hiperdenziteta. Kada se AFS komplikuje erozijom koštanog tkiva, na CT snimku se vidi i prekid kontinuiteta koštanog zida sinusa. Značajan laboratorijski nalaz, koji visoko korelira sa AFS, jesu visoko pozitivna imunoglobulin E (IgE) antitela (At) specifična za gljivice ustanovljena kožnim prick testom ili u serumu. Lečenje AFS je često hirurško, a nakon uklanjanja alergijskog mucina, primenjuju se lekovi: oralni i nazalni kortikosteroidi, imunoterapija i lokalno antimikotici kod dokazane gljivične etiologije. Tokom lečenja značajno je posmatranje ukupnog, odnosno specifičnog IgE, čija se koncentracija povećava s razvojem AFS, a smanjuje u stanju poboljšanja. Ipak, saznanja o patofiziološkim mehanizmima AFS su i dalje oskudna, zbog čega je on predmet daljih istraživanja čiji je cilj da se definiše optimalan dijagnostički i terapijski pristup.

Ključne reči

alergijski fungalni sinuzitis; patogeneza; kliničke odlike; laboratorijska dijagnoza

Reference

al Dousary, S.H. (2008) Allergic fungal sinusitis: Radiological and microbiological features of 59 cases. Ann Saudi Med, 28, (1), 1721
Allphin, A.L., Strauss, M., Abdul-Karim, F.W. (1991) Allergic fungal sinusitis: problems in diagnosis and treatment. Laryngoscope, 101(8): 815-20
Arsić-Arsenijević, V., Branković, M., Čolović, I., Džamić, A., Mitrović, S., Ratkov, E. (2010) Ispitivanje osetljivosti dermatofita na antimikotike. Srpski arhiv za celokupno lekarstvo, vol. 138, br. 7-8, str. 518-525
Azar, S., Mansour, B., Parivash, K., Babak, B. (2011) Fungal rhinosinusitis in hospitalized patients in Khorramabad, Iran. Middle-East Journal of Scientific Research, 7(3): 387-391
Balaban, J., Bogić, M., Stefanović, L., Stošović, R. (1999) Lečenje alergijske inflamacije steroidnim lekovima. Srpski arhiv za celokupno lekarstvo, 127(5-6): 202-205
Baloch, Z.A., Ahmad, A.N., Mahmood, Z., Rafi, S.M., Farooq, U., Qureshi, S., i dr. (2010) Frequency of allergic fungal sinusitis in patients with nasal polyposis and its causative species. Pakistan Journal of Otolaryngology, 26: 76-77
Bent, J.P., Kuhn, F.A. (1994) Diagnosis of allergic fungal sinusitis. Otolaryngol Head Neck Surg, 111(5): 580-8
Bent, J., Kuhn, F.A. (1996) Allergic fungal sinusitis/polyposis. Allergy Asthma Proc, 17, (5), 25968
Bradley, F., Marple, M.D. (2006) Allergic fungal rhinosinusitis: current theories and management strategies. Laryngoscope, 111(6): 1006-1019
Choi, S.S., Milmoe, G.J., Dinndorf, P.A., Quinones, R.R. (1995) Invasive Aspergillus sinusitis in pediatric bone marrow transplant patients. Evaluation and management. Arch Otolaryngol Head Neck Surg., 121(10): 188-192
Cody, D.T., Neel, H.B., Ferreiro, J.A., Roberts, G.D. (1994) Allergic fungal sinusitis: the Mayo Clinic experience. Laryngoscope, 104(9): 1074-9
de Shazo, R.D., Swain, R.E. (1995) Diagnostic criteria for allergic fungal sinusitis. Journal of allergy and clinical immunology, 96(1): 24-35
deShazo R.D., Chapin, K., Swain, R.E. (1997) Fungal sinusitis. New England journal of medicine, 337(4): 254-9
Dhiwakar, M., Thakar, A., Bahadur, S., Sarkar, C., Banerji, U., Handa, K.K., Chhabra, S.K. (2003) Preoperative diagnosis of allergic fungal sinusitis. Laryngoscope, 113(4): 688-94
El-Morsy, S.M., Khafagy, Y.W., El-Naggar, M.M., Beih, A.A. (2010) Allergic fungal rhinosinusitis: detection of fungal DNA in sinus aspirate using polymerase chain reaction. Journal of laryngology and otology, 124(2): 152-60
Ferguson, B.J. (2000) Eosinophilic mucin rhinosinusitis: a distinct clinicopatholohical entity. Laryngoscope, 5(1): 799-813
Ferreiro, J.A., Carlson, B.A., Cody, D.T. (1997) Paranasal sinus fungus balls. Head & neck, 19(6): 481-6
Glass, D., Amedee, R.G. (2011) Allergic fungal rhinosinusitis: A review. Ochsner J., 11(3):2715
Greenberger, P.A. (2002) Allergic bronchopulmonary aspergillosis. u: Grammar L.C., Greenberger P.A. [ur.] Pattersons Allergic Diseases, Philadelphia: Lippincott Williams & Wilkins, str. 52954
Kuhn, F.A., Javer, A.R. (2000) Allergic fungal sinusitis: a four-year follow-up. American journal of rhinology, 14(3): 149-56
Lanza, D.C., Kennedy, D.W. (1997) Adult rhinosinusitis defined. Otolaryngol Head Neck Surg, 117(3 Pt 2): S1-7
Lara, J.F., Gomez, J.D. (2001) Allergic mucin with and without fungus: a comparative clinicopathologic analysis. Archives of pathology & laboratory medicine, 125(11): 1442-7
Loury, M.C., Leopold, D.A., Schaefer, S.D. (1993) Allergic Aspergillus sinusitis. Archives of otolaryngology--head & neck surgery, 119(9): 1042-3
Lydiatt, W.M., Sobba-Higley, A., Huerter, J.V., Leibrock, L.G. (1994) Allergic fungal sinusitis with intracranial extension and frontal lobe symptoms: a case report. Ear, nose, & throat journal, 73(6): 402-4
Manning, S.C., Holman, M. (1998) Further evidence for allergic pathophysiology in allergic fungal sinusitis. Laryngoscope, 108(10): 1485-96
Manning, S.C., Merkel, M., Kriesel, K., Vuitch, F., Marple, B. (1997) Computed tomography and magnetic resonance diagnosis of allergic fungal sinusitis. Laryngoscope, 107(2): 170-6
Marple, B.F., Gibbs, S.R., Newcomer, M.T., Mabry, R.L. (1999) Allergic fungal sinusitis-induced visual loss. American journal of rhinology, 13(3): 191-5
McClay, J.E., Marple, B., Kapadia, L., Biavati, M.J., Nussenbaum, B., Newcomer, M., Manning, S., Booth, T., Schwade, N. (2002) Clinical presentation of allergic fungal sinusitis in children. Laryngoscope, 112(3): 565-9
Meltzer, E.O., Hamilos, D.L., Hadley, J.A., Lanza, D.C., Marple, B.F., Nicklas, R.A., Bachert, C., Baraniuk, J., Baroody, F.M., Benninger, M.S., Brook, I., Chowdhury, B.A., i dr. (2004) Rhinosinusitis: Establishing definitions for clinical research and patient care. Otolaryngol Head Neck Surg, 131(6 Suppl): S1-62
Mitchell, T.G. (2000) Overview of basic medical mycology. Otolaryngologic clinics of North America, 33(2): 237-49
Mitrović, S.M., Džamić, A.M., Arsić-Arsenijević, V.S., Radonjić, I.V., Kranjčić-Zec, I.F. (2007) Rezistencija gljiva na antimikotike - mehanizmi nastanka, učestalost, prevencija i kontrola rezistencije. Srpski arhiv za celokupno lekarstvo, vol. 135, br. 7-8, str. 486-494
Mukherji, S.K., Figueroa, R.E., Ginsberg, L.E., Zeifer, B.A., Marple, B.F., Alley, J.G., Cooper, L.L., Nemzek, W.R., Yousem, D.M., Jones, K.R., Kupferberg, S.B., Castillo, M. (1998) Allergic fungal sinusitis: CT findings. Radiology, 207(2): 417-22
Nawaz, G., Sattar, S.F. (2010) Presentation and diagnosis of allergic fungal sinusitis. Journal of Ayub Medical College, Abbottabad, 22(1): 53-7
Nussenbaum, B., Marple, B.F., Schwade, N.D. (2001) Characteristics of bony erosion in allergic fungal rhinosinusitis. Otolaryngol Head Neck Surg, 124(2): 150-4
Pekić, S., Arsić-Arsenijević, V.S., Skender-Gazibara, M.K., Milojević, T., Penđer, I.P., Stojanović, M., Popović, V.P. (2010) What lurks in the sellar?. Lancet, vol. 375, br. 9712, str. 432-432
Penđer, I., Boričić, I., Arsić, V., Dudvarski, Z., Dotlić, J., Jovičević, O., Janošević, Lj. (2009) Fungal sinusitis diagnostic management and classification. Acta chirurgica iugoslavica, vol. 56, br. 3, str. 145-148
Petković, L., Arsenijević, V.A., Skvarc, M., Kopitar, A., Kotnik, V., Simicic, S., Wraber, B., Matos, T., Ihan, A. (2010) Anticryptococcal cytotoxicity of murine nonadherent cells is perforin and nonperforin mediated. Mycologia, 102(3): 552-9
Ponikau, J.U., Sherris, D.A., Kern, E.B., Homburger, H.A., Frigas, E., Gaffey, T.A., Roberts, G.D. (1999) The diagnosis and incidence of allergic fungal sinusitis. Mayo Clin Proc, 74(9): 877-84
Robson, J.M., Hogan, P.G., Benn, R.A., Gatenby, P.A. (1989) Allergic fungal sinusitis presenting as a paranasal sinus tumour. Australian and New Zealand journal of medicine, 19(4): 351-3
Rupa, V., Jacob, M., Mathews, M.S., Job, A., Kurien, M., Chandi, S.M. (2002) Clinicopathological and mycological spectrum of allergic fungal sinusitis in South India. Mycoses, 45(9-10): 364-7
Safirstein, B.H. (1976) Allergic bronchopulmonary aspergillosis with obstruction of the upper respiratory tract. Chest, 70(6): 788-90
Saravanan, K., Panda, N.K., Chakrabarti, A., Das, A., Bapuraj, R.J. (2006) Allergic fungal rhinosinusitis: an attempt to resolve the diagnostic dilemma. Archives of otolaryngology--head & neck surgery, 132(2): 173-8
Scheinberg, P.A., Otsuji, A. (2002) Nebulized antibiotics for the treatment of acute exacerbations of chronic rhinosinusitis. Ear, nose, & throat journal, 81(9): 648-52
Schubert, M.S., Goetz, D.W. (1998) Evaluation and treatment of allergic fungal sinusitis. I. Demographics and diagnosis. Journal of allergy and clinical immunology, 102(3): 387-94
Schubert, M.S. (2001) Fungal rhinosinusitis: Diagnosis and therapy. Curr Allergy Asthma Rep, 1, (3), 26876
Sellart-Altisent, M., Torres-Rodríguez, J.M., de Gómez, A.S., Alvarado-Ramírez, E. (2007) Nasal fungal microbiota in allergic and healthy subjects. Revista iberoamericana de micología, 24(2): 125-30
Singh, N., Bhalodiya, N.H. (2005) Allergic fungal sinusitis (AFS)--earlier diagnosis and management. Journal of laryngology and otology, 119(11): 875-81
Slavin, R.G., Spector, S.L., Bernstein, I.L., Kaliner, M.A., Kennedy, D.W., Virant, F.S., i dr. (2005) The diagnosis and management of sinusitis: a practice parameter update. J Allergy Clin Immunol, Suppl
Trpkovic, A., Pekmezovic, M., Barac, A., Crncevic-Radovic, L., Arsic-Arsenijevic, V.S. (2012) In vitro antifungal activities of amphotericin B, 5-fluorocytosine, fluconazole and itraconazole against Cryptococcus neoformans isolated from cerebrospinal fluid and blood from patients in Serbia. Journal De Mycologie Medicale, vol. 22, br. 3, str. 243-248
Venarske, D.L., deShazo Richard, D. (2002) Sinobronchial allergic mycosis: the SAM syndrome. Chest, 121(5): 1670-6