Journal List > Allergy Asthma Respir Dis > v.6(3) > 1095179

Yang, Park, Kim, Lee, Kim, Chun, Yoon, Kim, and Kim: The association between nasal eosinophilia and aeroallergen sensitization in children and adolescents with rhinitis

Abstract

Purpose

To identify the correlation between nasal eosinophilia and aeroallergen sensitization in children and adolescents.

Methods

This is a retrospective study of patients below 18 years of age who had a history of rhinitis that lasted more than 2 weeks or had been repeated more than once a year, received nasal eosinophil examinations, and had serum specific IgE to aeroallergens measured at an Allergy Clinic in a single tertiary teaching hospital in Seoul, Korea. The percentage of nasal eosinophils was calculated by the number of eosinophils per total leukocytes in a high-power field of 1,000× . Data was analyzed to determine the association between nasal eosinophilia and 18 aeroallergens.

Results

Of the 245 patients included, 156 (63.7%) were male and the mean age (±standard deviation) was 7.9 years (±3.8). In total, 175 patients (71.4%) were sensitized to at least 1 of the 18 aeroallergens tested, and sensitization to house dust mite was most common. In addition, 118 (48.2%) and 69 patients (28.2%) had nasal eosinophilia of at least 1% and 5%, respectively. There were no significant correlations between serum total IgE or age and the percentage of nasal eosinophils. However, the percentage of nasal eosinophils in the group sensitized to any aeroallergens was significantly increased compared to the nonsensitized group (P=0.002). The percentage of nasal eosinophils was significantly higher in patients who were sensitized to Birch-Alder Mix, oak white, Bermuda grass, orchard grass, timothy grass, sweet vernal grass, rye, mugwort, short ragweed, Alternaria alternata, cats, dogs or Dermatophagoides farinae compared to those nonsensitized.

Conclusion

Nasal eosinophilia was significantly associated with sensitization to aeroallergens.

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Fig. 1.
Comparison of nasal eosinophils according to sensitization to inhalant allergens. Mann-Whitney test was used for statistical analysis. ∗ P<0.05.
aard-6-161f1.tif
Fig. 2.
Correlation between nasal eosinophils and serum total IgE in 106 patients. Nasal eosinophils tended to increase with increasing total IgE level but not statistically significant.
aard-6-161f2.tif
Fig. 3.
Correlation of nasal eosinophils to age. There was no correlation between nasal eosinophils and age.
aard-6-161f3.tif
Table 1.
Characteristics of study participants (n=245)
Characteristic Value
Age (yr)  
 Mean±SD 7.9±3.8
 Median (IQR) 7.0 (1–17)
Male sex 156 (63.7)
Eosinophils in nasal smear (% of total leukocytes), median (IQR) 0 (0–7)
Clinical diagnosis  
 AR 59 (24.1)
 AR + paranasal sinusitis 40 (16.3)
 AR + asthma or wheezing 33 (13.5)
 AR + common cold 11 (4.5)
 Paranasal sinusitis 46 (18.8)
 Asthma or wheezing 5 (2.0)
 Common cold 17 (6.9)
 NARES 4 (1.6)
 Other rhinitis 30 (12.2)
Sensitization to aeroallergen  
 Birch-Alder mix 25 (10.2)
 White oak 15 (6.1)
 Bermuda grass 30 (12.2)
 Orchard grass 42 (17.1)
 Timothy grass 37 (15.1)
 Sweet vernal grass 40 (16.3)
 Rye 39 (15.9)
 Mugwort 23 (9.4)
 Short ragweed 22 (9.0)
 Japanese hop 22 (9.0)
Alternaria alternata 18 (7.3)
Aspergillus 1 (0.4)
Cladosporium 5 (2.0)
 Cat 44 (18.0)
 Dog 36 (14.7)
 Cockroach 6 (2.4)
D. farinae 136 (55.5)
D. pteronyssinus 138 (56.3)

Values are presented as number (%) unless otherwise indicated.

SD, standard deviation; IQR, interquartile range; AR, allergic rhinitis; NARES, nonallergic rhinitis with eosinophilia syndrome; D, farina, Dermatophagoides farina; D. pteronyssinus, Dermatophagoides pteronyssinus.

Underlying disease is a clinical diagnosis when examination of nasal eosinophil wasperformed.

Table 2.
Comparison of nasal eosinophils according to sensitization to inhalant allergen
Aeroallergen Nasal eosinophils (%) P-value
Antigen-specific IgE postive Antigen-specific IgE negative
No. Median (IQR) No. Median (IQR)
Tree          
 Birch-Alder mix 25 9 (0–44) 220 0 (0–5) 0.006
 White oak 15 4 (0–46) 230 0 (0–5) 0.028
Grass          
 Bermuda grass 30 3 (0–40.5) 215 0 (0–5) 0.024
 Orchard grass 42 3 (0–29.3) 203 0 (0–4) 0.007
 Timothy grass 37 3 (0–27) 208 0 (0–4.8) 0.007
 Sweet vernal grass 40 3 (0–23.3) 205 0 (0–4.5) 0.013
Weed          
 Rye 39 4 (0–30) 206 0 (0–3.3) 0.002
 Mugwort 23 4 (0–42) 222 0 (0–5) 0.029
 Short ragweed 22 10 (0–43) 223 0 (0–5) 0.009
 Japanese hop 22 3 (0–40.5) 223 80 (0–5) 0.065
Mold          
Alternaria alternata 18 12.5 (0.8–59.8) 227 0 (0–5) 0.001
Aspergillus 1 15 244 0 (0–6.5) 0.192
Cladosporium 5 15 (0–61.5) 240 0 (0–5) 0.221
Animal          
 Cat 44 1.5 (0–22) 201 0 (0–5) 0.030
 Dog 36 1.5 (0–15) 209 0 (0–5) 0.047
 Cockroache 6 1.5 (0–10.5) 239 0 (0–7) 0.920
HDM          
D. farinae 136 1 (0–14.3) 109 0 (0–2.5) 0.027
D. pteronyssinus 138 0 (0–10.3) 107 0 (0–3) 0.523

IQR, interquartile range; HDM, house dust mite; D, farina, Dermatophagoides farina; D. pteronyssinus, Dermatophagoides pteronyssinus.

P<0.05.

Mann-Whitney test.

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