CHRONIC SINUSITIS. RELATIONSHIP OF COMPUTED TOMOGRAPHIC FINDINGS TO ALLERGY, ASTHMA, AND EOSINOPHILIA

Abstract

Extensive sinusitis by CT scan is more highly associated with patients with asthma, allergy (as defined by positive RAST to inhalant allergens), and peripheral and tissue eosinophilia. None of the factors were sensitive enough to predict limited involvement on CT scan. The most striking correlation was between peripheral eosinophilia and extensive disease. This correlation was still highly significant among patients without a history of wheezing and those that were RAST-negative. The authors concluded that there is little evidence to support an IgE- mediated mechanism for extensive sinus disease or the eosinophilia in RAST-negative patients. This suggests that it is the inflammation of the sinus mucosa rather than coexistent asthma or allergy that is the stimulus for peripheral eosinophilia. Assuming that the inflammation in the sinuses and the resultant eosinophilia are antigen-driven, it remains to be clarified what the relevant antigens are.