Die Bedeutung eosinophiler Granulozyten in Beziehung zu Allergie und Aspirin-Intoleranz bei Patienten mit Sinusitis polyposa

BACKGROUND: The development of nasal polyps might be influenced by different factors such as mucosal inflammation. Infiltration with eosinophils is a common finding, although in largely different quantitis. PATIENTS AND METHODS: We investigated 58 patients suffering from nasal polyps who were assigned for endonasal sinus surgery based on endoscopic and CT findings. Out of these patients, 52% have already had sinus surgery and had recurrent polyps. All patients were subjected to both, allergy testing and a functional in vitro test for aspirin intolerance. During surgery, tissue samples were gained and send for histological examination with special respect to eosinophil infiltration. RESULTS: Eosinophil infiltration was observed in 66% of all patients. 37 patients (64%) exhibited aspirin intolerance only, four (7%) had a positive allergy test only, in 9 patients (15%) both, allergy and aspirin intolerance were diagnosed. Allergy and aspirin intolerance were accompanied by eosinophil tissue infiltration. Eosinophil infiltration was more common and more severe if allergy and aspirin intolerance were found together compared with the tissue eosinophilia in patients with either one entity. CONCLUSION: This study confirms the importance of eosinophil infiltration in the pathogenesis of severe or recurrent nasal polyps based on allergy and aspirin intolerance. A coincidance of allergy and aspirin intolerance was found in an unexpected high number of patients.