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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.
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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.
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.
Fig. 3.
Correlation of nasal eosinophils to age. There was no correlation between nasal eosinophils and age.
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) |
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 |
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