Middle turbinate edema as a diagnostic marker of inhalant allergy

Background Middle turbinate edema could be a characteristic feature of aeroallergen sensitization. In this study we sought to determine the diagnostic characteristics of middle turbinate edema as a marker of inhalant allergy. Methods A cross‐sectional diagnostic study was performed on patients who h...

Full description

Saved in:
Bibliographic Details
Published in:International forum of allergy & rhinology 2017-01, Vol.7 (1), p.37-42
Main Authors: Hamizan, Aneeza W., Christensen, Jenna M., Ebenzer, Jareen, Oakley, Gretchen, Tattersall, Jessica, Sacks, Raymond, Harvey, Richard J.
Format: Article
Language:English
Subjects:
Adult
Allergens - immunology
allergic
atopy
Edema - diagnosis
Edema - immunology
Edema - pathology
Endoscopy
Female
Humans
Hypersensitivity - diagnosis
Hypersensitivity - immunology
Hypersensitivity - pathology
Male
Middle Aged
middle turbinate
Nasal Cavity - pathology
nasal polyp
rhinitis
Rhinitis - diagnosis
Rhinitis - immunology
Rhinitis - pathology
Skin Tests
turbinates
Turbinates - pathology
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Middle turbinate edema could be a characteristic feature of aeroallergen sensitization. In this study we sought to determine the diagnostic characteristics of middle turbinate edema as a marker of inhalant allergy. Methods A cross‐sectional diagnostic study was performed on patients who had undergone nasal endoscopy and allergy testing. Allergy status was determined by positive serology or epicutaneous testing. Endoscopy was reviewed by blinded assessors for middle turbinate head edema. Appearance was graded as either normal, focal, multifocal, diffuse, or polypoid edema. Receiver‐operator (ROC) analysis, likelihood ratio (LR), sensitivity, specificity, and positive predictive value (PPV) were determined. Results One hundred eighty‐seven patients representing 304 nasal cavities were assessed (42% female, age 39.74 ± 14.7 years, 57% allergic). Diffuse edema (PPV 91.7%/LR = 8) and polypoid edema (PPV 88.9%/LR = 6.2) demonstrated the strongest association with inhalant allergy. Multifocal edema was used as a cut‐off to represent inhalant allergy from ROC analysis, which demonstrated 94.7% specificity and 23.4% sensitivity. The PPV for multifocal was 85.1% and LR = 4.4. Conclusion Middle turbinate edema is a useful nasal endoscopic feature to predict presence of inhalant allergy and, although not sensitive, has excellent PPV.
ISSN:2042-6976
2042-6984
DOI:10.1002/alr.21835