Diagnostic value of serum and tissue eosinophil in diagnosis of asthma among patients with chronic rhinosinusitis
Background: Chronic rhinosinusitis (CRS) is one of the most common chronic inflammatory diseases of sinonasal mucosa. Asthma among CRS patients is often underdiagnosed and causes management of CRS more challenging. Therefore, using serum and tissue eosinophil as an indicator and prediction of ast...
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| Main Author: | |
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| Format: | Thesis |
| Language: | English |
| Published: |
2022
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| Subjects: | |
| Online Access: | http://eprints.usm.my/60645/1/Che%20Mohd%20Hilmi%20Che%20Mat-E.pdf |
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| Summary: | Background: Chronic rhinosinusitis (CRS) is one of the most common chronic inflammatory
diseases of sinonasal mucosa. Asthma among CRS patients is often underdiagnosed and
causes management of CRS more challenging. Therefore, using serum and tissue eosinophil
as an indicator and prediction of asthma in CRS patients are valuable for further preventing
recurrent and increase 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.
Method: A cross-sectional study was conducted involving 24 CRS patients with and without
asthma respectively from the Otorhinolaryngology clinic of two tertiary hospitals located in
the East Coast of Peninsular Malaysia. Serum and tissue eosinophils (obtained from nasal
polyp) between both groups were compared. Association between serum and tissue
eosinophils with asthma 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 (ROC) 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 x109/L] and
tissue eosinophil [100 vs 8.5 per HPF]. 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 ROC curve for serum eosinophil was 69.0%. At optimal cutoff
value (0.375 x109/L), the sensitivity and specificity for serum eosinophil was 75.0% and
70.8%. The area under the ROC curve for tissue eosinophil was 93.4%. At optimal cut-off
value (58.0 per HPF), the sensitivity and specificity for tissue eosinophil were 79.2% and
91.7% respectively.
Conclusion: A significantly higher level of serum and tissue eosinophil are seen in CRS with
asthma. However, there was no correlation between serum and tissue eosinophil in both
groups. The CRS patient needs to be screened for asthma if the level of serum eosinophil is
more than 0.375 x 109/L and tissue eosinophil more than 58 per HPF. |
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