A STUDY ON PREDICTION OF ALLERGIC FUNGAL RHINOSINUSITIS WITH SERUM IGE LEVELS

Background: Allergic fungal rhinosinusitis (AFRS) with IgE mediated allergic pathogenesis is a category of non-invasive fungal sinusitis. In our study, we followed up patients with AFRS who have undergone functional endoscopic sinus surgery and correlated endoscopic appearance (Kupferberg staging) with pre and postoperative total serum IgE levels. Objectives: 1. To assess preoperative and postoperative endoscopic staging as well as total serum IgE levels in patients with AFRS who underwent functional sinus surgery. 2. To assess the sensitivity of total serum IgE level in predicting the disease status in patients with AFRS on postoperative follow up. Methodology: Aprospective longitudinal cohort study was done on 68 patients diagnosedtohave AFRS. Preoperative endoscopic staging was done along with total serum IgE levels and skin allergy test for all patients. Postoperatively the patients underwent repeat endoscopy and serum IgE level testing at 4 to 7 months follow up. Results: We had 68 patients in the age group of 21-60 years in the study. The majority of the patients in the study group were males (61.8%). In our study, 54 of 68 patients had a fall in postoperative total serum IgE levels when compared to their preoperative values. The sensitivity of total serum IgE levels in this study was, therefore, 84%. The specificity of total serum IgE level was only 33.3% in our study. Conclusion: In this study on patients with AFRS who underwent total serum IgE estimation and rigid nasal endoscopy both pre and post operatively shows that total serum IgE levels is a fairly good prognostic measure in patients with AFRS. Eventhough the test specificity is low, both total serum IgE levels and clinical findings together may be ideal to asses the prognosis for the individual patients with AFRS.