Sublingual Immunotherapy for Allergic Fungal Sinusitis

Allergic fungal sinusitis (AFS) is a condition that has an allergic basis caused by exposure to fungi in the sinonasal tract leading to chronic inflammation. Despite standard treatment modalities, which typically include surgery and medical management of allergies, patients still have a high rate of...

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Bibliographic Details
Published in:Annals of otology, rhinology & laryngology rhinology & laryngology, 2015-10, Vol.124 (10), p.782-787
Main Authors: Melzer, Jonathan M., Driskill, Brent R., Clenney, Timothy L., Gessler, Eric M.
Format: Article
Language:English
Subjects:
Adult
Allergens - administration & dosage
Chronic Disease
Environmental Illness - blood
Environmental Illness - diagnosis
Environmental Illness - therapy
Female
Fungi - immunology
Humans
Immunoglobulin E - blood
Male
Medical Records, Problem-Oriented
Secondary Prevention - methods
Sinusitis - blood
Sinusitis - diagnosis
Sinusitis - therapy
Sublingual Immunotherapy - methods
Treatment Outcome
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Summary:Allergic fungal sinusitis (AFS) is a condition that has an allergic basis caused by exposure to fungi in the sinonasal tract leading to chronic inflammation. Despite standard treatment modalities, which typically include surgery and medical management of allergies, patients still have a high rate of recurrence. Subcutaneous immunotherapy (SCIT) has been used as adjuvant treatment for AFS. Evidence exists to support the use of sublingual immunotherapy (SLIT) as a safe and efficacious method of treating allergies, but no studies have assessed the utility of SLIT in the management of allergic fungal sinusitis. A record review of cases of AFS that are currently or previously treated with sublingual immunotherapy from 2007 to 2011 was performed. Parameters of interest included serum IgE levels, changes in symptoms, Lund-McKay scores, decreased sensitization to fungal allergens associated with AFS, and serum IgE levels. Ten patients with diagnosed AFS were treated with SLIT. No adverse effects related to the use of SLIT therapy were identified. Decreases in subjective complaints, exam findings, Lund-McKay scores, and serum IgE levels were observed. Thus, sublingual immunotherapy appears to be a safe adjunct to the management of AFS that may improve patient outcomes.
ISSN:0003-4894
1943-572X
DOI:10.1177/0003489415583686