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Review
. 2014 Dec 16;2(12):873-82.
doi: 10.12998/wjcc.v2.i12.873.

Eosinophilic chronic rhinosinusitis in East Asians

En-Tong Wang  1 , Yan Zheng  1 , Peng-Fei Liu  1 , Li-Juan Guo  1
Affiliations
Review

Eosinophilic chronic rhinosinusitis in East Asians

En-Tong Wang et al. World J Clin Cases. .

Abstract

Chronic rhinosinusitis (CRS) is a common disease worldwide, with a prevalence rate of 5%-15% in the general population. CRS is currently classified into two types: CRS with and without nasal polyps. CRS may also be divided into eosinophilic CRS (ECRS) and non-ECRS subtypes based on the presence of tissue eosinophilic infiltration or not. There are significant geographic and ethnic differences in the tissue eosinophilic infiltration, which is predominant in Western white patients and less common in East Asians, despite an increasing tendency for its prevalence in East Asia countries. ECRS differs significantly from non-ECRS in clinical characteristics, treatment outcomes and strategies, and underlying pathogenic mechanisms. ECRS commonly demonstrates more severe symptoms, polyp diseases with a higher incidence of bilateral polyps and sinonasal diseases on computed tomography, and the increase in blood eosinophils. ECRS is considered a special and recalcitrant subtype of CRS, commonly with poor treatment outcomes compared to non-ECRS. The differentiation of specific subtypes and clinical features of CRS will be important for developing novel treatment strategies and improving treatment outcomes for individual phenotypes of CRS. This review discusses clinical features, diagnosis, treatment and prognosis of ECRS in East Asians.

Keywords: Chronic rhinosinusitis; Chronic rhinosinusitis with nasal polyps; Eosinophilic chronic rhinosinusitis; Eosinophils; Nasal polyps.

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Figures

Figure 1
Figure 1
Hematoxylin and eosin staining for nasal polyp tissues. Predominant eosinophil infiltration is showed in the subtype of eosinophilic chronic rhinosinusitis with nasal polyps (A), but other forms of inflammatory cell infiltration in the subtype of non-eosinophilic chronic rhinosinusitis with nasal polyps (B) (× 400).
Figure 2
Figure 2
Nasal endoscopic findings. Polyps in eosinophilic chronic rhinosinusitis with nasal polyps (A) and in non-eosinophilic chronic rhinosinusitis with nasal polyps (B).
Figure 3
Figure 3
Computed tomography findings. Axial and frontal sections in the subtypes of eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) (A and C) and non-eosinophilic chronic rhinosinusitis with nasal polyps (NECRSwNP) (B and D). Predominant diseases in bilateral anterior and posterior ethmoid sinuses are showed in ECRSwNP, while predominant diseases in anterior ethmoid sinuses in NECRSwNP.
Figure 4
Figure 4
Frequency distribution and range of tissue eosinophil count per high power field for 60 patients with chronic rhinosinusitis with nasal polyps.
See this image and copyright information in PMC

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