Abstract
Objective: The pathogenesis of chronic rhinosinusitis is still unclear. A variety of factors are thought to be involved in the pathogenesis of chronic paranasal sinusitis. We sought to identify the phenotypes of chronic paranasal sinusitis patients by means of a cluster analysis.
Method: We conducted a retrospective analysis of prospectively collected data from April 2007 to March 2008 in a multicenter study involving 5 hospitals.
Results: The cluster analysis yielded 6 phenotypes: Cluster 1(n = 102), low blood and tissue eosinophil counts; Cluster 2 (n = 118), slightly increased blood and tissue eosinophil counts, but higher CT polyp score than in Cluster 1; Cluster 3 (n = 84), moderately elevated IgE level and high blood eosinophil counts, but mild increase in tissue eosinophil counts, and common aspirin-tolerant asthma as comorbidity; Cluster 4 (n = 69), extremely high tissue eosinophil counts, but mild blood eosinophil increase; Cluster 5 (n = 20), hyperimmunoglobulinemia E and specific IgE antibodies to fungi and house dust mites; Cluster 6 (n = 6), all aspirin-intolerant.
Conclusion: Chronic rhinosinusitis was classified into 6 phenotypes according to the eosinophil, IgE, asthma, and nasal polyp findings. The pathogenesis of chronic paranasal sinusitis needs to be further investigated by including cases of recurrent disease.
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