European Journal of Rhinology and Allergy
Original Article

Change in Serum IgE Levels Following Surgery in Patients with Allergic Fungal Rhinosinusitis is Predictive of Disease Status

1.

Departments of ENT (Rhinology and Anterior Skull Base Unit) and Biostatistics, Christian Medical College, Vellore, India

Eur J Rhinol Allergy 2021; 4: 58-61
DOI: 10.5152/ejra.2021.21317
Read: 106 Downloads: 41 Published: 31 August 2021

Objective: We aimed to correlate post-operative endoscopic disease status and reduction in serum total IgE levels in patients with allergic fungal rhinosinusitis (AFRS) and to ascertain whether this reduction has prognostic significance.

Material and Methods: A prospective cohort of 50 patients with biopsy-proven AFRS underwent preoperative endoscopy and serum total IgE assessment. Following endoscopic excision of polyps and allergic mucin and postoperative steroid therapy, patients were re-evaluated at 3-6months with nasal endoscopy with Kupferberg staging and serum total IgE levels.

Results: There were 27 (54%) male and 23 (46%) female patients. Preoperative endoscopy showed grade 3 polyps in 33 (66%) patients and grade 2 polyps in 17 (34%) patients. Post-operatively, 37 (74%) patients had Stage 0, 11 (22%) had Stage 1, and two (4%) had Stage 2 diseases. Preoperative IgE levels ranged from 153.2 to 6,548.2 IU mL1. Postoperative IgE levels were reduced in 42 of 50 (84%) patients and ranged from 79.9 to 3,900 IU mL1. There was a negative correlation between percentage change in IgE and post-operative endoscopic score, which was significant (r ¼ 0.25; P ¼ .032). Based on receiver operating characteristic analysis, a percentage reduction in IgE of 32% had a sensitivity of 69.2% (95% CI: 38.6-90.9) and specificity of 67.6% (95% CI: 50.2-82.0) in predicting endoscopic stage.

Conclusion: Post-operative reduction in serum total IgE levels negatively correlates with endoscopic stage in AFRS patients who undergo surgery and post-operative steroid therapy. A cutoff of 32% in change in IgE levels is predictive of endoscopic Stage 0 disease.

Cite this article as: Aravind V, Joy N, Mani T, Rupa V. Change in Serum IgE Levels Following Surgery in Patients with Allergic Fungal Rhinosinusitis is Predictive of Disease Status. Eur J Rhinol Allergy. 2021;4(2):58-61.

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