Background: Nasal polyposis is a common nasal mass with unknown etiology. It has been assumed that allergy predisposes to polyp formation. Our objective was to compare the prevalence of food sensitization in medically resistant chronic rhinosinusitis patients with or without nasal polyposis. Methods: One hundred and fifty-five patients who fulfilled the inclusion and exclusion criteria were incorporated into this study. The results of their total serum IgE and food-specific IgE levels were examined. Results: The average age was 33 years (± 13) with 96 males and 59 females. The percentage of patients in each group that had a positive result for at least one tested allergen was 84% (88 patients in the sinusitis without polyposis group and 42 patients in nasal polyposis group). Patients without nasal polyposis reacted to an average of 4.6 foodstuffs, whereas patients with nasal polyposis reacted to 4.1. Egg white, sheefish and cherry were the most common type of sensitized food. There were no significant differences in the prevalence, type, number of positive food allergens and class level between the two groups. Conclusions: Food sensitization is common in medically resistant chronic rhinosinusitis. Since food sensitization prevalence, type and severity do not significantly differ between the two groups studied, food atopy is unlikely to be a major factor in nasal polyposis pathogenesis.

Keywords:
Rhinosinusitis, Serology, Food sensitization, Sinus surgery, Atopy, Nasal polyposis
1.
Hastan D, Fokkens WJ, Bachert C, et al: Chronic rhinosinusitis in Europe - an underestimated disease: a GA²LEN study. Allergy 2011;66:1216-1223.
2.
Wilson KF, McMains KC, Orlandi RR: The association between allergy and chronic rhinosinusitis with and without nasal polyps: an evidence-based review with recommendations. Int Forum Allergy Rhinol 2014;4:93-103.
3.
King WP: Food hypersensitivity in otolaryngology: manifestations, diagnosis, and treatment. Otolaryngol Clin North Am 1992;25:163-179.
4.
Pang YT, Eskici O, Wilson JA: Nasal polyposis: role of subclinical delayed food hypersensitivity. Otolaryngol Head Neck Surg 2000;122:298-301.
5.
Collins MM, Loughran S, Davidson P, Wilson JA: Nasal polyposis: prevalence of positive food and inhalant skin tests. Otolaryngol Head Neck Surg 2006;135:680-683.
6.
Lill C, Loader B, Seemann R, et al: Milk allergy is frequent in patients with chronic sinusitis and nasal polyposis. Am J Rhinol Allergy 2011;25:e221-e224.
7.
Doğru H, Tüz M, Uygur K, Akkaya A, Yasan H: Asymptomatic IgE mediated food hypersensitivity in patients with nasal polyps. Asian Pac J Allergy Immunol 2003;21:79-82.
8.
Bhombal S, Bothwell MR, Bauer SM: Prevalence of elevated total IgE and food allergies in a consecutive series of ENT pediatric patients. Otolaryngol Head Neck Surg 2006;134:578-580.
9.
Eigenmann PA, Sicherer SH, Borkowski TA, Cohen BA, Sampson HA: Prevalence of IgE-mediated food allergy among children with atopic dermatitis. Pediatrics 1998;101:E8.
10.
Sampson HA, McCaskill CC: Food hypersensitivity and atopic dermatitis: evaluation of 113 patients. J Pediatr 1985;107:669-675.
11.
Sampson HA, Scanlon SM: Natural history of food hypersensitivity in children with atopic dermatitis. J Pediatr 1989;115:23-27.
12.
Bock SA, Atkins FM: Patterns of food hypersensitivity during sixteen years of double-blind, placebo-controlled food challenges. J Pediatr 1990;117:561-567.
13.
Sicherer SH: Epidemiology of food allergy. J Allergy Clin Immunol 2011;127:594-602.
14.
Sicherer SH, Sampson HA: Food allergy. J Allergy Clin Immunol 2010;125:S116-S125.
15.
Kurowski K, Boxer RW: Food allergies: detection and management. Am Fam Physician 2008;77:1678-1686.
16.
Eckman J, Saini SS, Hamilton RG: Diagnostic evaluation of food-related allergic diseases. Allergy Asthma Clin Immunol 2009;5:2.
17.
Asero R, Fernandez-Rivas M, Knulst AC, Knulst AC, Bruijnzeel-Koomen CA: Double-blind, placebo-controlled food challenge in adults in everyday clinical practice: a reappraisal of their limitations and real indications. Curr Opin Allergy Clin Immunol 2009;9:379-385.
18.
Sampson HA: Food allergy. JAMA 1997;278:1888-1894.
19.
Stone KD, Prussin C, Metcalfe DD: IgE, mast cells, basophils, and eosinophils. J Allergy Clin Immunol 2010;125:S73-S80.
20.
Klink M, Cline MG, Halonen M, Halonen M, Burrows B: Problems in defining normal limits for serum IgE. J Allergy Clin Immunol 1990;85:440-444.
21.
Sunyer J, Antó JM, Castellsagué J, Soriano JB, Roca J: Total serum IgE is associated with asthma independently of specific IgE levels. The Spanish Group of the European Study of Asthma. Eur Respir J 1996;9:1880-1884.
22.
Tschopp JM, Sistek D, Schindler C, et al: Current allergic asthma and rhinitis: diagnostic efficiency of three commonly used atopic markers (IgE, skin prick tests, and Phadiatop): results from 8,329 randomized adults from the SAPALDIA Study - Swiss Study on Air Pollution and Lung Diseases in Adults. Allergy 1998;53:608-613.
23.
Mehl A, Verstege A, Staden U, et al: Utility of the ratio of food-specific IgE/total IgE in predicting symptomatic food allergy in children. Allergy 2005;60:1034-1039.
© 2016 S. Karger AG, Basel
2016
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.