Sinobronchial Allergic Mycosis: Materials and Methods
One copy of the D1270N mutation in the CFTR gene was detected. Sweat chloride concentrations, as determined by quantitative pilocarpine iontophoresis on each arm, were 19 and 24 mEq/L, with a normal range of < 40 mEq/L.
Postoperatively, the patient was treated with 0.5 mg/kg prednisone daily for 1 month plus topical nasal steroids by inhalation, montelukast sodium (10 mg/d), and nasal lavages (Water-Pik; Water-Pik Technologies; Newport Beach, CA; with a Grossan adapter; Hydromed, Inc, Sherman Oaks, CA) with a saline solution. He received allergen immunotherapy in a single injection for the fungal allergens from which IgE was detected. The patient also received a second immunotherapy injection containing the tree, grass, and weed allergens for which the skin-prick test was positive.
Postoperatively, the patient has been observed in our clinic. His total IgE levels fell to 5,055 kU/L, 3,675 kU/L, and 2,470 kU/L in subsequent months. After 1 month, therapy with oral corticosteroids was switched to alternate-day administration of prednisone (10 mg every other day) website buy proventil. At the present time, the patient continues to do well while receiving these medications, with decreasing total IgE levels. He receives surveillance rhinoscopy every 3 months to assess for the reoccurrence of polyps. Evidence of the airways obstruction that was initially present on pulmonary function testing has resolved. Genetic counseling has been provided by a certified genetic counselor.
Computer-based literature searches were used to identify all case reports of concomitant AFS and ABPM in the medical literature published in English (MEDLINE; National Library of Medicine; Bethesda, MD). These case reports were carefully reviewed, and the findings were compared to those for our patient.