potential role of macrophage migration inhibitory factor in house dust nasal allergy

The role of macrophage migration inhibitory factor [MIF] was studied in patients with house dust nasal allergy. Macrophage migration inhibition test [MIT] was done for 30 patients with house dust nasal allergy. In 43% of the patients; nasal allergy was associated with other atopic diseases as bronchial asthma, atopic dermatitis and allergic conjunctivitis. Patients were clinically classified into: seasonal, perennial allergic rhinitis and perennial with seasonal exacerbation groups. 20 healthy subjects served as a control group. Eosinophilia was detected in all patients. 80% of the patients had positive MIT as compared to 60% in healthy individuals. The difference between the two groups was statistically insignificant [p > 0.05], while there was a significant difference in the mean value of MIT results between the two groups [p < 0.05]. In addition, there was significant association between the production of MIF and the severity of allergic manifestations and the presence of other atopic disease. On the other hand there was no significant association between the production of MIF and the type of nasal allergy. It is concluded that the production of MIF by allergen-stimulated T-Iymphocytes may be a useful laboratory parameter to comprehend the clinical course of the disease

Paranasal sinuses involvement in rhinoscleroma, CT, endoscopic and histopathological study

Rhinoscleroma is a chronic granulomatous inflammatory disease of the upper respiratory tract of an insidous onset, slowly progressive course and benign in nature. This Study was conducted at Oto-Rhino-laryngology and Radiodiagnosis departments in Ain Shams University Hospitals. It included 50 rhinoscleroma patients, 28 females, 22 males, and their age ranged from 17-50 years. All patients were examined by CT-scans of paranasal sinuses, sinoscopy, and histopathological study of suspected tissues. Positive CT. findings were detected in 30 out of 50 cases [60%], while positive maxillary sinus lesions were seen by sinoscopy in 32 out of 50 [64%] in the form of thick polypoidal mucosa, granuloma and atrophic mucosa with secretions, while actual antroscleroma by the histopathological study was found in 11 cases [22%]. Anterior ethmoiditis with occlusion of osteomeatal complex was detected in 16 cases, while anterior and posterior ethmoiditis in 4 cases, sphenoid sinusitis was also seen in 3 cases by CT-scans. In this study, it was found, that CT-scan is reliable and helpfull diagnostic procedure in the detection of extent of rhinoscleroma in paranasal sinuses. Sinoscopy of the paranasal sinuses provided accurate information about the nature of mucosal changes, the presence of secretions and the state of natural ostium

Irreversibility of mucosal damage in chronic sinusitis: could it be diagnosed?

The point of irreversibility of mucosal damage in chronic sinusitis is both difficult to define and to assess. Therefore, the management of this condition is usually based on vague personal judgement and preference. In this study, 22 whole antral specimens were obtained during Caldwell - Lucs operations on 13 patients suffering from chronic maxillary sinusitis. 16 antra harbered extensive lesions while 6 antra harbered localised lesions. In both groups, the spectrum of histopathological findings were the same. In addition both of them showed areas of healthy mucosa intervening with areas of diseased mucosa denoting high potentiality of repair of damaged mucosa if adequate sinus drainage and ventilation were instituted. The results support a functional and conservative management in most cases of chronic sinusitis whether of localised or of extensive pathologies