Clinical features of patients showing Candida hypersensitivity: an observational study.

BACKGROUND The significance of Candida albicans as an allergen is still unclear. This study aimed at investigating the clinical features of patients monosensitized to Candida. METHODS Thirty-four adult patients monosensitized to the yeast Candida albicans selected from a population of >7000 subjects and referred for suspect respiratory allergy were studied. Ninety subjects monosensitized to different airborne allergens served as controls. Both patients and controls underwent a clinical examination at the ENT department to detect possible nasal polyps. RESULTS Male and female patients were equally distributed (17/17). The mean age of the patients was 58.4 years (range 23-75 years; median 59 years) vs 29.9 years (range 9-62 years) in controls (p <0.001). At baseline examination, 15 (44%) patients vs 5/90 (6%) controls were diagnosed as having nasal polyposis (p< 0.001). Polyposis was bilateral in 13/15 (87%) patients; 3 had "massive" polyps, and 4 had a clinical history of prior surgical intervention to remove nasal polyps. Eight patients (24%) had asthma, previously diagnosed as intrinsic in six cases. No patient had a history of aspirin-induced asthma (i.e. ASA triad). After one year 1/11 (9%) patients without polyps at the baseline examination had developed bilateral nasal polyposis. CONCLUSION Candida-hypersensitivity is uncommon, occurs in older ages, and is strongly associated with nasal polyposis.