Allergy Asthma Respir Dis.  2020 Jan;8(1):15-19. 10.4168/aard.2020.8.1.15.

The diagnostic usefulness and correlation of nasal eosinophil count and percentage in children with rhinitis

Affiliations
  • 1Department of Pediatrics, School of Medicine, The Catholic University of Korea, Seoul, Korea. journey237@catholic.ac.kr

Abstract

PURPOSE
Allergic rhinitis is the most common atopic disease and the most common chronic disease of children. Eosinophil count and percentage in nasal smear are useful for differential diagnosis of allergic rhinitis. The aim of this study is to investigate the correlation between nasal eosinophil count and percentage.
METHODS
Between January 2017 and August 2018, 221 children patients with a clinical history of rhinitis were tested at the outpatient respiratory and allergy unit of the Department of Pediatrics, School of Medicine, The Catholic University of Korea. Nasal secretion was collected by swabbing a children's nasal inferior turbinate 3-4 times with a cotton swab and then placed on to a glass slide. Later, the smear was stained by Giemsa stain.
RESULTS
This is the first study to assess the comparison of nasal eosinophil count and percent. There is a positive correlation between nasal eosinophil count and percent Y=1.02 X+2.82 (Y=Eosinophil count, X=Eosinophil percentage). To determine the usefulness of nasal eosinophil count and percentage in the diagnosis of allergic rhinitis, we analyzed receiver operating characteristic curves. The cutoff value of the nasal eosinophil count was 6.5/high-power field, and that of the nasal eosinophil ratio was 3% for the diagnosis of allergic rhinitis.
CONCLUSION
In patients with suspected rhinitis, one of the values of nasal eosinophil count or percentage can be used in clinical practice.

Keyword

Rhinitis; Nasal eosinophil; Correlation; Diagnosis; Child

MeSH Terms

Azure Stains
Child*
Chronic Disease
Diagnosis
Diagnosis, Differential
Eosinophils*
Glass
Humans
Hypersensitivity
Korea
Outpatients
Pediatrics
Rhinitis*
Rhinitis, Allergic
ROC Curve
Turbinates
Azure Stains

Figure

  • Fig. 1 (A) Correlation between nasal eosinophil count and nasal eosinophil percentage in all patients. (B) Correlation between nasal eosinophil count and nasal eosinophil percentage in the children with AR. (C) Correlation between nasal eosinophil count and nasal eosinophil percentage in the children with non-AR. AR, allergic rhinitis.

  • Fig. 2 (A) The mean value of nasal eosinophil counts in the children with AR was higher than the children with non-AR. (B) The mean value of nasal eosinophil percentage in the children with AR was higher than the children with non-AR. AR, allergic rhinitis.

  • Fig. 3 (A) Comparison of areas under the receiver operating characteristic curves between nasal eosinophil counts for diagnosis of AR. The area under the curve was 0.71 (95% confidence interval [CI], 0.65–0.77; P<0.01) and the optimal cutoff value to distinguish patients with AR was 6.5/HFP. AR, allergic rhinitis. (B) Comparison of areas under the receiver operating characteristic curves between nasal eosinophil percentage for diagnosis of AR. The area under the curve was 0.71 (95% CI, 0.65–0.78; P<0.01) and the optimal cutoff value to distinguish patients with AR was 3%. AR, allergic rhinitis.


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