Sinobronchial Allergic Mycosis: Conclusion
The relationship between CFTR gene mutations and AFS is unknown. The possibility that CFTR gene mutations also may contribute to the development of AFS or put patients with either ABPM or AFS at risk for the development of the SAM syndrome requires further study. An epidemiologic survey found that persons heterozygous for the AF508 mutations have a higher prevalence of skin-prick tests positive for Aspergillus fumigatus.33 Additional immunologic alterations that have been associated with CFTR gene mutations include reduced levels of interleukin-10, a potent anti-inflammatory cytokine, in the lungs of patients with CF.
In summary, we conclude that patients with coexistent AFS and ABPM present with symptoms of either or both diseases and are without clinical features to distinguish those with coexistent disease from those with isolated disease. Buy allegra online Source The clinician should, therefore, routinely consider the diagnosis of SAM in patients who have either AFS or ABPM. Patients with coexistent disease have chronic sinusitis and wheezing, and usually require sinus surgery. They have variable chest radiographic appearances at the initial evaluation, although most have pulmonary infiltrates. Although the response to initial corticosteroid therapy is good, the long-term prognosis to this condition is unclear. The associations among mutations in the CFTR gene, ABPM, AFS, and the SAM syndrome require further study.