Rinossinusite fúngica alérgica – série de casos e revisão da literatura
Allergic fungal rhinosinusitis – case series and literature review
Daniela de Abreu e Silva Martinez; Priscila Novaes Ferraiolo; Fabiana Chagas da-Cruz; Lucas Abreu Arantes; Maria Luiza Oliva Alonso; Solange Oliveira Rodrigues Valle; Sergio Duarte Dortas-Junior
Resumo
A rinossinusite fúngica alérgica é um subtipo não invasivo de rinossinusite crônica com pólipos nasais com inflamação do tipo 2. É caracterizada por sensibilização a fungos IgE mediada, mucina alérgica e achados característicos de tomografia computadorizada e ressonância magnética nos seios paranasais. O diagnóstico é classicamente feito usando os critérios de Bent & Kuhn. No entanto, estudos recentes indicaram a falta de especificidade de alguns critérios importantes. O tratamento na maioria das vezes é cirúrgico, e a terapia adjuvante consiste principalmente no uso de esteroides orais e/ou tópicos. O omalizumabe, dupilumabe e mepolizumabe estão atualmente aprovados para o tratamento da rinossinusite crônica com pólipos nasais em geral, mas os ensaios clínicos até o momento com esses produtos biológicos não envolveram pacientes com rinossinusite fúngica alérgica. Descrevemos as principais características dos pacientes diagnosticados com rinossinusite fúngica alérgica de um hospital universitário e revisamos os dados atuais da literatura sobre o tema.
Palavras-chave
Abstract
Allergic fungal rhinosinusitis is a noninvasive subtype of chronic rhinosinusitis with nasal polyps associated with type 2 inflammation. It is characterized by immunoglobulin E-mediated fungal sensitization, the presence of allergic mucin, and typical computed tomography and magnetic resonance imaging findings in paranasal sinuses. Diagnosis is classically established using the Bent & Kuhn criteria; however, recent studies have indicated a lack of specificity for some of the major criteria. Treatment almost always requires surgery, and adjunctive therapy mainly consists of oral and/or topical corticosteroids. Omalizumab, dupilumab, and mepolizumab are currently approved for the treatment of chronic rhinosinusitis with nasal polyps in general, but clinical trials with these biologics have not included patients with allergic fungal rhinosinusitis. Here, we describe the main characteristics of patients diagnosed with allergic fungal rhinosinusitis treated in a university hospital, along with a literature review of published data.
Keywords
Referências
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Aceito em:
01/02/2025
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