Sage Journals: Discover world-class research

Abstract

Background

Chronic rhinosinusitis (CRS) and eosinophilic esophagitis (EoE) are immune-mediated inflammatory conditions that share common histopathologic features. Once considered two separate pathologies, preliminary data has suggested that a higher prevalence of EoE may exist in patients with CRS.

Objectives

We aimed to expand the base of evidence across geographic regions and investigate the association between EoE and CRS, including CRS with nasal polyposis (CRSwNP).

Methods

Quantitative data detailing the prevalence of CRS, CRSwNP, and EoE were pooled from 6 large academic institutions spread across the United States using Epic electronic medical record system. One-way analysis of variance was then used to analyze the data.

Results

The mean prevalence of EoE in our general population sample of over 26 million individual records was 0.058% (range, 0.013%-0.103%). The mean prevalence of EoE in our sub-populations of individual with diagnoses of CRS and CRSwNP was 0.43% (F(1,12) = [8.194], P = .01) and 0.84% (F(1,12) = [23.61], P < .01) respectively.

Conclusion

This study reveals an 8-fold greater prevalence of concurrent EoE in patients with CRS. Importantly, this is the first study to describe the association of EoE and the CRSwNP subtype, and we demonstrate a 14-fold greater prevalence of EoE in patients with CRSwNP.

Keywords

chronic rhinosinusitis rhinitis sinusitis nasal polyposis eosinophilic esophagitis nasal obstruction rhinorrhea post-nasal drip Th2-mediated inflammation immune-mediated inflammation

Get full access to this article

View all access options for this article.

References

Akdis

. Does the epithelial barrier hypothesis explain the increase in allergy, autoimmunity and other chronic conditions? Nat Rev Immunol. 2021;21(11):739–751.

Celebi Sozener Z, Cevhertas L, Nadeau K, Akdis M, Akdis CA. Environmental factors in epithelial barrier dysfunction. J Allergy Clin Immunol. 2020;145(6):1517–1528.

Sugita

Kabashima

. Tight junctions in the development of asthma, chronic rhinosinusitis, atopic dermatitis, eosinophilic esophagitis, and inflammatory bowel diseases. J Leukoc Biol. 2020;107(5):749–762.

Kumar

Choi

Gupta

. Eosinophilic esophagitis - a primer for otolaryngologists. JAMA Otolaryngol Head Neck Surg. 2019;145(4):373–380.

Kottyan

Rothenberg

. Genetics of eosinophilic esophagitis. Mucosal Immunol. 2017;10(3):580–588.

O'Shea

, Aceves SS, Dellon ES, et al. Pathophysiology of eosinophilic esophagitis. Gastroenterology. 2018;154(2):333–345.

Orlandi RR, Kingdom TT, Smith TL, et al. International consensus statement on allergy and rhinology: rhinosinusitis 2021. Int Forum Allergy Rhinol. 2021;11(3):213–739.

Dellon

Hirano

. Epidemiology and natural history of eosinophilic esophagitis. Gastroenterology. 2018;154(2):319–332.e3.

Hamilos

. Chronic rhinosinusitis: epidemiology and medical management. J Allergy Clin Immunol. 2011;128(4):693–707; quiz 708-9.

10.

Padia R, Curtin K, Peterson Kathryn, Orlandi RR, Alt J. Eosinophilic esophagitis strongly linked to chronic rhinosinusitis. Laryngoscope. 2016;126(6):1279–1283.

11.

Dauer EH, Freese DK, El-Youssef M, Thompson DM. Clinical characteristics of eosinophilic esophagitis in children. Ann Otol Rhinol Laryngol. 2005;114(11):827–833.

12.

Rybnicek DA, Hathorn KE, Pfaff ER, Bulsiewicz WJ, Shaheen NJ, Dellon ES. Administrative coding is specific, but not sensitive, for identifying eosinophilic esophagitis. Dis Esophagus. 2014;27(8):703–708.

Increased Prevalence of Eosinophilic Esophagitis in Patients With Chronic Rhinosinusitis