title: Clinical Examination of Tissue Eosinophilia in Patients with Chronic Rhinosinusitis and Nasal Polyposis.
abstract: (1) Describe clinical and histopathologic findings in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). (2) Determine if tissue and serum eosinophilia predicts disease severity in CRSwNP.
  
  
  
  Case series with chart review.
  
  
  
  Academic hospital specializing in respiratory and allergic disease.
  
  
  
  Patients with CRSwNP treated from 2008 to 2010.
  
  
  
  Clinical data were collected; sinus computed tomography (CT) scans were scored according to the Lund-Mackay system; and surgical specimens were evaluated for degree of tissue eosinophilia. Statistical analysis was performed to compare eosinophilia with indicators of disease severity.
  
  
  
  Seventy CRSwNP patients were included, with a mean Lund-Mackay score of 16.7; 62.1% of patients had severe asthma, and 62.9% were aspirin sensitive. Elevated tissue eosinophil level did not correlate with medication usage, olfactory symptoms, or Lund-Mackay scores, nor did it correlate with presence of asthma or aspirin-sensitivity (P = .09). Patients with mild asthma had significantly more tissue eosinophils versus patients with severe asthma, possibly because of the high amount of chronic corticosteroid use in severe asthmatics. There was no correlation between tissue and serum eosinophil counts (P = .97), but there was a significant positive correlation between CT score and peripheral eosinophil level (P < .05).
  
  
  
  Higher serum eosinophil levels may indicate more extensive mucosal disease as measured on CT scan. Neither serum nor tissue eosinophilia predicted disease severity in our retrospective analysis of CRSwNP patients, and serum eosinophil level did not serve as a marker of tissue eosinophilia.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Gitomer
authors.affiliation: Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, USA.
authors.forename: Cynthia R
authors.initials: CR
authors.lastname: Fountain
authors.affiliation: Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado, USA.
authors.forename: Todd T
authors.initials: TT
authors.lastname: Kingdom
authors.affiliation: Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado, USA.
authors.forename: Anne E
authors.initials: AE
authors.lastname: Getz
authors.affiliation: University of Colorado School of Medicine, Aurora, Colorado, USA.
authors.forename: Stefan H
authors.initials: SH
authors.lastname: Sillau
authors.affiliation: National Jewish Health, Division of Allergy and Immunology, Denver, Colorado, USA.
authors.forename: Rohit K
authors.initials: RK
authors.lastname: Katial
authors.affiliation: Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado, USA vijay.ramakrishnan@ucdenver.edu.
authors.forename: Vijay R
authors.initials: VR
authors.lastname: Ramakrishnan
mesh_terms: D001241:Aspirin / Q000009:adverse effects; D001249:Asthma / Q000150:complications; D002908:Chronic Disease; D004342:Drug Hypersensitivity; D004802:Eosinophilia / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000000981:diagnostic imaging* / Q000601:surgery*; D012189:Retrospective Studies; D012220:Rhinitis / Q000000981:diagnostic imaging* / Q000601:surgery*; D012720:Severity of Illness Index; D012852:Sinusitis / Q000000981:diagnostic imaging* / Q000601:surgery*; D014057:Tomography, X-Ray Computed
chemical_list: D001241:Aspirin
keywords: allergy; aspirin exacerbated respiratory disease; asthma; chronic sinusitis; nasal polyps