Serum IgE as a prognostic marker of fungus in chronic rhino sinusitis with nasal polyposis

Objective: To assess the relationship of total serum IgE level in anticipating the manifestation of fungus in chronic rhinosinusitis with nasal polyposis (CRSwNP). Methodology: This observational study was carried out at Dow University Hospital, Dow International Medical College, DUHS, Karachi from June 2015 to June 2017. Patients with CRSwNP diagnosed on anterior rhinoscopy and rigid nasal endoscopy were treated medically for 1 month by clarithromycin 500 mg daily for 30 days, topical nasal steroids (mometasone furoate 200 mu g daily, or fluticasone furoate 110 mu g daily), and oral steroid therapy (methylprednisolone 0.5 mg/kg/day with tapering off doses). Results: Twenty-six patients (29.9%) had a positive culture for fungus; however, the double density sign was positive in 25 (28.7%) patients and 39 (44.8%) patients were suspected of having fungus during surgical exploration of sinuses. Conclusion: A strong association between raised degrees of serum IgE with polyps, intensifying polyp seriousness, and AFS, which in general can be used as a screening for the presence and reaction to treatment of fungal infection in paranasal sinuses prompting early acknowledgment of AFS.