Food Sensitization in Medically Resistant Chronic Rhinosinusitis with or without Nasal Polyposis

Abstract

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.

International consensus statement on allergy and rhinology: rhinosinusitis 2021

“…Lill et al found a strong association between CRSwNP and milk allergy, 1397 though neither wheat nor overall incidence of food sensitivity differed between diseased and healthy populations. Other studies comparing systemic IgE for food sensitivity between CRSsNP and CRSwNP demonstrated no such relationship, 1398 with Al‐Quodah finding, “no significant differences in the prevalence, type, number of positive food allergens and class level between the 2 groups.” 1399 These studies present conflicting evidence for the role of food allergy in the pathogenesis of CRSwNP disease (Table X‐5).…”

Prevalence of IgE‐mediated sensitization in patients with suspected food allergic reactions in Jordan

“…Apart from a questionnaire‐based survey estimating the prevalence of FA in schoolchildren aged 6 to 14 in Al‐Karak governorate in the south of Jordan, 16 and an FS screen of a small cohort of medically resistant chronic rhinosinusitis patients, 17 we were unable to find any published epidemiological work about FS or FA in the country, despite an extensive literature search.…”

Exploring the association between ingestion of foods with higher potential salicylate content and symptom exacerbation in chronic rhinosinusitis. Data from the National Chronic Rhinosinusitis Epidemiology Study

“…The Chronic Rhinosinusitis Epidemiology Study is the largest epidemiological study of CRS in the UK to date and is believed to be the first study to collect data on patient reported symptom exacerbation in response to ingestion of foods with higher potential salicylate content in CRS subtypes other than the N-ERD subgroup. Other studies investigating sensitivity to foodstuffs in CRS subgroups have focused on non-specific food sensitisation and delayed food hypersensitivity measured by skin prick testing 12,13 .…”