Total IgE levels and peripheral eosinophilia: correlation with mucosal disease based on computed tomographic imaging of the paranasal sinus

OBJECTIVE: To evaluate the relationship among peripheral eosinophilia, total IgE, and paranasal sinus mucosal disease based on computed tomography (CT) of the sinus. DESIGN: Retrospective review of a large medical information database from a tertiary referral medical center. SETTING: Tertiary referral medical center specializing in respiratory disorders. PATIENTS: Consecutive patients having total IgE and peripheral eosinophil levels and sinus CT imaging available for review. Patients 18 years or older were included; subjective or objective evidence of chronic rhinosinusitis was not used as selection criteria. A total of 303 patients were found to have peripheral eosinophil levels and CT imaging for review; 288 patients had total IgE levels and CT imaging. MAIN OUTCOME MEASURES: Linear regression analysis was used to evaluate (1) the correlation between peripheral eosinophil level and CT stage of sinus disease and (2) the correlation between total IgE level and CT stage of sinus disease. The CT scans were graded using the Lund-MacKay scoring system. RESULTS: There was a significant positive correlation between sinus CT stage and peripheral eosinophil levels (r=0.60, P<.05). Eighty-nine percent of the abnormal eosinophil counts (>550 cells/microL) were associated with CT scores higher than 12. Total IgE did not correlate with CT stage of disease (r=0.05, P>.05). CONCLUSIONS: The presence of peripheral eosinophilia indicates a high likelihood of mucosal sinus disease based on CT imaging. No correlation was noted between total IgE levels and CT stage of mucosal disease. These data support a link between eosinophilia and the presence of paranasal sinus mucosal inflammation.