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. 2016 Jul-Aug;4(4):658-664.e1.
doi: 10.1016/j.jaip.2015.11.031. Epub 2016 Jan 20.

African American Patients with Chronic Rhinosinusitis Have a Distinct Phenotype of Polyposis Associated with Increased Asthma Hospitalization

Mahboobeh Mahdavinia  1 , Mohamed Benhammuda  2 , Christopher D Codispoti  2 , Mary C Tobin  2 , Philip S Losavio  3 , Arpita Mehta  2 , Jill S Jeffe  3 , Sindhura Bandi  2 , Anju T Peters  4 , Whitney W Stevens  4 , Alan Landay  2 , Ali Keshavarzian  4 , Robert P Schleimer  5 , Pete S Batra  3
Affiliations

African American Patients with Chronic Rhinosinusitis Have a Distinct Phenotype of Polyposis Associated with Increased Asthma Hospitalization

Mahboobeh Mahdavinia et al. J Allergy Clin Immunol Pract. 2016 Jul-Aug.

Abstract

Background: Chronic rhinosinusitis (CRS) is a common inflammatory disease of the upper airways that is often categorized into subtypes including "with" and "without" nasal polyps. However, the influence of multiple important epidemiologic factors, including race, on CRS has not been investigated.

Objective: The present study assessed various phenotypic characteristics of CRS in patients, living in the United States, with different racial backgrounds.

Methods: We performed a large retrospective cohort study of patients with CRS treated at a large urban tertiary care referral center in Chicago.

Results: African American (AA) patients with CRS living in Chicago were more likely to report hyposmia as a symptom of CRS. Furthermore, AA patients with CRS who failed medical therapy and required surgical intervention had a significantly higher frequency of nasal polyposis and aspirin-exacerbated respiratory disease, and a higher disease severity index on computed tomography imaging than did white patients with CRS. The increased polyposis in AAs was associated with increased hospitalization for asthma. There were no differences in the prevalence of atopy, asthma, atopic dermatitis, food allergy, duration of disease, or number of surgeries between different races.

Conclusions: AAs with refractory CRS are at increased risk for nasal polyposis, smell loss, aspirin-exacerbated respiratory disease, and a greater severity of disease based on imaging, resulting in increased health care utilization.

Keywords: African American; Asthma; Chronic rhinosinusitis (CRS); Nasal polyp; Race.

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Conflict of interest statement

Conflicts of interest: A. T. Peters has received consultancy fees from Greer and Baxter. R. P. Schleimer has received research support from the National Institutes of Health; has received consultancy fees from Intersect ENT, GlaxoSmithKline, Allakos, Aurasense, Merck, BioMarck, and Sanofi; and has stock/stock options in Allakos, Aurasense, and BioMarck. The rest of the authors declare that they have no relevant conflicts of interest.

Figures

FIGURE 1
FIGURE 1
CRSwNP is associated with higher risk of smell loss (A) and higher LMSs (B) in all races, and is associated with increased ER visits (C) and hospitalizations (D) for asthma only in AAs.
See this image and copyright information in PMC

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