Nasal polyps: An independent risk factor for bronchial hyperresponsiveness in patients with allergic rhinitis.
BACKGROUND
Many studies were conducted to figure out the relationship between allergic rhinitis (AR) and lower airway diseases. This study was designed to elucidate the clinical parameters that could predict the coexistence of bronchial hyperresponsiveness (BHR) in AR and suggest a guideline for lower airway evaluation in these patients.


METHODS
One hundred seventy-three patients newly diagnosed with AR were evaluated for the lower airway with the methacholine bronchoprovocation test.


RESULTS
BHR was more prevalent in patients with nasal polyps (p = 0.01), in patients complaining of moderate to severe symptoms (p = 0.023), with higher serum total IgE levels (p = 0.001), and with blood eosinophil count (p = 0.008). No statistically significant difference was observed between intermittent and persistent AR patients (p = 0.364). Blood eosinophil count that could predict BHR was calculated as 320 cells/μL (p = 0.004).


CONCLUSIONS
Instead of a routine lower airway evaluation for all AR patients, we recommend lower airway evaluation for the selected patients with nasal polyps, moderate to severe symptoms, and high blood eosinophil count.
Departments of Otorhinolaryngology, Seoul National University Hospital, Korea.
Youngjin
Y
Ahn
Soo-Youn
SY
An
Tae-Bin
TB
Won
Jeong-Whun
JW
Kim
Chul Hee
CH
Lee
Yang-Gi
YG
Min
Sang Heon
SH
Cho
Heung Woo
HW
Park
Young Yull
YY
Koh
Sun Sin
SS
Kim
Chae-Seo
CS
Rhee
D000293:Adolescent; D000328:Adult; D000368:Aged; D016535:Bronchial Hyperreactivity / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D004804:Eosinophils / Q000502:physiology; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications*; D012221:Rhinitis, Allergic, Perennial / Q000150:complications*; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications*; D012307:Risk Factors
D007073:Immunoglobulin E