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. 2023 May;280(5):2283-2291.
doi: 10.1007/s00405-022-07746-4. Epub 2022 Nov 18.

Diagnostic value of serum and tissue eosinophil in diagnosis of asthma among patients with chronic rhinosinusitis

Che Mohd Hilmi Che Mat  1   2 , Norasnieda Md Shukri  3 , Sakinah Mohamad  1 , Sharifah Emilia Tuan Sharif  4 , Rosdi Ramli  2 , Murni Hartini Jais  5 , Mat Zuki Mat Jaeb  6 , Najib Majdi Yaacob  7 , Mohd Yusran Yusoff  8 , Siti Muhamad Nur Husna  9 , Baharudin Abdullah  1
Affiliations

Diagnostic value of serum and tissue eosinophil in diagnosis of asthma among patients with chronic rhinosinusitis

Che Mohd Hilmi Che Mat et al. Eur Arch Otorhinolaryngol. 2023 May.

Abstract

Background: Chronic rhinosinusitis (CRS) is one of the most common chronic inflammatory diseases of sinonasal mucosa. Asthma among CRS patients is often underdiagnosed which makes the management of CRS more challenging. Therefore, using serum and tissue eosinophil as an indicator and predictor of asthma in CRS patients is vital for further preventing recurrent and increasing the effectiveness of treatment for CRS.

Objective: To determine the association and diagnostic ability of serum and tissue eosinophils in the diagnosis of asthma among CRS patients.

Methods: A cross-sectional study was conducted involving 24 CRS patients with asthma and without asthma, respectively, from the Otorhinolaryngology clinic of two tertiary hospitals located on the East Coast of Peninsular Malaysia. Serum and tissue eosinophils (obtained from nasal polyp) levels between both groups were compared. Association between serum and tissue eosinophils with asthma was evaluated using logistic regression analysis, adjusting for important sociodemographic characteristics. The diagnostic ability of serum and tissue eosinophil was then evaluated by assessing the receiver operating characteristic curve.

Results: A total of 48 CRS patients with a mean [SD] age of 47.50 [14.99] years were included. Patients with asthma had significantly higher serum [0.48 vs 0.35 × 109/L] and tissue eosinophil [100 vs 8.5 per HPF] levels. Tissue eosinophils were found to be an independent predictor of asthma with adjusted OR 1.05, p < 0.001, after adjusting for age and serum eosinophils. The area under the receiver operating characteristic curve for serum eosinophil was 69.0%. At optimal cut-off value (0.375 × 109/L), the sensitivity and specificity for serum eosinophil was 75.0% and 70.8%. The area under the receiver operating characteristic curve for tissue eosinophil was 93.4%. At the optimal cut-off value (58.0 per HPF), the sensitivity and specificity for tissue eosinophils were 79.2% and 91.7%, respectively.

Conclusion: This study indicates a significantly higher level of serum and tissue eosinophils in CRS with asthma. However, there was no correlation between serum and tissue eosinophils in both group. Based on this study, the CRS patient needs to be screened for asthma if the level of serum eosinophil is > 0.375 × 109/L and tissue eosinophil > 58 per HPF.

Keywords: Asthma; Chronic rhinosinusitis; Endoscopic; Nasal polyp; Serum eosinophil; Tissue eosinophil.

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References

    1. Hastan D et al (2011) Chronic rhinosinusitis in Europe–an underestimated disease. A GA2LEN study. Allergy 66(9):1216–1223 - DOI - PubMed
    1. Murphy MP et al (2002) Health care utilization and cost among adults with chronic rhinosinusitis enrolled in a health maintenance organization. Otolaryngol Head Neck Surg 127(5):367–376 - DOI - PubMed
    1. Hedman J et al (1999) Prevalence of asthma, aspirin intolerance, nasal polyposis and chronic obstructive pulmonary disease in a population-based study. Int J Epidemiol 28(4):717–722 - DOI - PubMed
    1. Settipane GA, Chafee FH (1977) Nasal polyps in asthma and rhinitis: a review of 6,037 patients. J Allergy Clin Immunol 59(1):17–21 - DOI - PubMed
    1. Ahn J-C et al (2016) Prevalence and risk factors of chronic rhinosinusitus, allergic rhinitis, and nasal septal deviation: results of the Korean National Health and Nutrition Survey 2008–2012. JAMA otolaryngol Head Neck Surg 142(2):162–167 - DOI - PubMed