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Original ArticleOpen Access
Eosinophilic Mucin Rhinosinusitis : Terminology and Clinicopathological Presentation
Aeumjaturapat S 
,
Saengpanich S ,
lsipradit P ,
Keelawat S
,
Saengpanich S ,
lsipradit P ,
Keelawat S :Terminology and Cli-
SUPINDA SAENGPANICH,MD*,
SOMBOON KEELA W AT, MD**
Many terms related to allergic fungal rhinosinusitis (AFRS) such as eosinophilic mucin
rhinosinusitis (EMRS), eosinophilic fungal rhinosinusitis (EFRS), and AFRS-like syndrome have been
proposed. The authors define EMRS as patients with rhinosinusitis who demonstrate eosinophilic
mucin on histopathological examination. EMRS patients who demonstrate fungal hyphae within the
mucin are diagnosed as having EFRS and those who cannot demonstrate fungal hyphae within the
mucin are diagnosed as having EFRS-like syndrome. EFRS patients who demonstrate an allergic res-
ponse to the fungi are diagnosed as having AFRS and those who cannot demonstrate any allergic res-
ponses to the fungi are diagnosed as having non-allergic fungal rhinosinusitis (NAFRS). In the United
States, the prevalence of AFRS in chronic rhinosinusitis patients who require surgery is 5-10 per cent.
However, the prevalence of AFRS in Thailand is not known because AFRS has never been reported
and studied in Thailand. This study shows the clinical and pathological entities of patients with EMRS
in King Chulalongkorn Memorial Hospital from July 2001 to July 2002. From a total of two hundred
and fourteen rhinosinusitis patients who required surgery, six were diagnosed as having EMRS. Two
of six EMRS patients were diagnosed as having EFRS (both of them were also diagnosed as having
AFRS) and four patients were diagnosed as having EFRS-like syndrome. In this study, the prevalence
of AFRS is much less than in the United States because of the limited understanding of this disease,
the lack of commercially available antigens for dematiaceous fungi, and the lack of awareness and
knowledge of pathologists to diagnose eosinophilic mucin and fungi within the mucin. The terms related
to AFRS are also discussed in this study.
Key word
: Allergic Fungal Rhinosinusitis, Eosinophilic Mucin Rhinosinusitis, Eosinophilic Fungal
Rhinositins, Allergic Fungal Rhinosinusitis Like Syndrome
SUPINDA SAENGPANICH,MD*,
SOMBOON KEELA W AT, MD**
Many terms related to allergic fungal rhinosinusitis (AFRS) such as eosinophilic mucin
rhinosinusitis (EMRS), eosinophilic fungal rhinosinusitis (EFRS), and AFRS-like syndrome have been
proposed. The authors define EMRS as patients with rhinosinusitis who demonstrate eosinophilic
mucin on histopathological examination. EMRS patients who demonstrate fungal hyphae within the
mucin are diagnosed as having EFRS and those who cannot demonstrate fungal hyphae within the
mucin are diagnosed as having EFRS-like syndrome. EFRS patients who demonstrate an allergic res-
ponse to the fungi are diagnosed as having AFRS and those who cannot demonstrate any allergic res-
ponses to the fungi are diagnosed as having non-allergic fungal rhinosinusitis (NAFRS). In the United
States, the prevalence of AFRS in chronic rhinosinusitis patients who require surgery is 5-10 per cent.
However, the prevalence of AFRS in Thailand is not known because AFRS has never been reported
and studied in Thailand. This study shows the clinical and pathological entities of patients with EMRS
in King Chulalongkorn Memorial Hospital from July 2001 to July 2002. From a total of two hundred
and fourteen rhinosinusitis patients who required surgery, six were diagnosed as having EMRS. Two
of six EMRS patients were diagnosed as having EFRS (both of them were also diagnosed as having
AFRS) and four patients were diagnosed as having EFRS-like syndrome. In this study, the prevalence
of AFRS is much less than in the United States because of the limited understanding of this disease,
the lack of commercially available antigens for dematiaceous fungi, and the lack of awareness and
knowledge of pathologists to diagnose eosinophilic mucin and fungi within the mucin. The terms related
to AFRS are also discussed in this study.
Key word
: Allergic Fungal Rhinosinusitis, Eosinophilic Mucin Rhinosinusitis, Eosinophilic Fungal
Rhinositins, Allergic Fungal Rhinosinusitis Like Syndrome
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